Provider Demographics
NPI:1568534816
Name:KULA, AYSE OGE (MD)
Entity type:Individual
Prefix:DR
First Name:AYSE
Middle Name:OGE
Last Name:KULA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:AYSE
Other - Middle Name:OGE
Other - Last Name:ERDEM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 735044
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60673-5044
Mailing Address - Country:US
Mailing Address - Phone:800-326-2250
Mailing Address - Fax:
Practice Address - Street 1:8901 W LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:WEST ALLIS
Practice Address - State:WI
Practice Address - Zip Code:53227-2409
Practice Address - Country:US
Practice Address - Phone:414-328-6000
Practice Address - Fax:414-649-1328
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI49591-020207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100006530Medicaid
WI1568534816Medicaid