1518932144 NPI number — STELIAN MARINESCU MD PC

Table of content: (NPI 1518932144)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518932144 NPI number — STELIAN MARINESCU MD PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
STELIAN MARINESCU MD PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1518932144
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/11/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1193 COPPERWOOD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BLOOMFIELD TWP
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48302
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
313-359-3652
Provider Business Mailing Address Fax Number:
313-359-3654

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
23100 CHERRY HILL
Provider Second Line Business Practice Location Address:
SUITE 5
Provider Business Practice Location Address City Name:
DEARBORN
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48124
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
313-359-3652
Provider Business Practice Location Address Fax Number:
313-359-3654
Provider Enumeration Date:
02/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MARINESCU
Authorized Official First Name:
STELIAN
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER MANAGING AGENT
Authorized Official Telephone Number:
313-359-3652

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X , with the licence number:  4301053643 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 4344019 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com