Basic Information
Provider Information
NPI: 1275523623
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: AKYUREK
FirstName: MUSTAFA
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 415348
Address2:  
City: BOSTON
State: MA
PostalCode: 022410001
CountryCode: US
TelephoneNumber: 8002258885
FaxNumber: 5083341977
Practice Location
Address1: 281 LINCOLN ST
Address2: DEPARTMENT OF PLASTIC SURGERY
City: WORCESTER
State: MA
PostalCode: 016052138
CountryCode: US
TelephoneNumber: 5083345958
FaxNumber: 5083345152
Other Information
ProviderEnumerationDate: 10/26/2005
LastUpdateDate: 11/02/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/02/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2086S0122X221218MAY Allopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery

ID Information
IDTypeStateIssuerDescription
110039482A05MA MEDICAID
208523205MA MEDICAID


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