Basic Information
| Provider Information | |||||||||
| NPI: | 1043507007 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | OLGUN | ||||||||
| FirstName: | GULSAH | ||||||||
| MiddleName: | |||||||||
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| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | VURAL | ||||||||
| OtherFirstName: | GULSAH | ||||||||
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| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 750 E 29TH ST | ||||||||
| Address2: | |||||||||
| City: | FREMONT | ||||||||
| State: | NE | ||||||||
| PostalCode: | 680252384 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4027532900 | ||||||||
| FaxNumber: | 4027532926 | ||||||||
| Practice Location | |||||||||
| Address1: | 1205 S GRANGE AVE STE 307 | ||||||||
| Address2: | |||||||||
| City: | SIOUX FALLS | ||||||||
| State: | SD | ||||||||
| PostalCode: | 571050410 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6053287800 | ||||||||
| FaxNumber: | 6053287899 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/28/2011 | ||||||||
| LastUpdateDate: | 03/31/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/31/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 28962 | NE | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.