Basic Information
| Provider Information | |||||||||
| NPI: | 1205298403 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | UCISIK-KESER | ||||||||
| FirstName: | FEHIME | ||||||||
| MiddleName: | EYMEN | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | UCISIK | ||||||||
| OtherFirstName: | FEHIME | ||||||||
| OtherMiddleName: | EYMEN | ||||||||
| OtherNamePrefix: | |||||||||
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| OtherCredential: | M.D. | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 3001 S HANOVER ST | ||||||||
| Address2: | DEPT OF INTERNAL MEDICINE | ||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212251233 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4103503565 | ||||||||
| FaxNumber: | 4103540186 | ||||||||
| Practice Location | |||||||||
| Address1: | 3001 S HANOVER ST | ||||||||
| Address2: | DEPT OF INTERNAL MEDICINE | ||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212251233 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4103503565 | ||||||||
| FaxNumber: | 4103540186 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/26/2016 | ||||||||
| LastUpdateDate: | 03/26/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.