Provider Demographics
NPI:1124659016
Name:IANCU, MIHAI (PA-C)
Entity type:Individual
Prefix:MR
First Name:MIHAI
Middle Name:
Last Name:IANCU
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Gender:M
Credentials:PA-C
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Other - Credentials:
Mailing Address - Street 1:4301 WILSON ST.
Mailing Address - Street 2:RAHC
Mailing Address - City:FORT SILL
Mailing Address - State:OK
Mailing Address - Zip Code:73503-6300
Mailing Address - Country:US
Mailing Address - Phone:580-558-2770
Mailing Address - Fax:580-558-3200
Practice Address - Street 1:4301 WILSON ST.
Practice Address - Street 2:RAHC
Practice Address - City:FORT SILL
Practice Address - State:OK
Practice Address - Zip Code:73503-6300
Practice Address - Country:US
Practice Address - Phone:580-558-2780
Practice Address - Fax:580-558-3200
Is Sole Proprietor?:No
Enumeration Date:2020-01-29
Last Update Date:2024-03-13
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant