Provider Demographics
NPI:1275320137
Name:ANTONESCU, MARIA (COMMUNITY MIDWIFE)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:ANTONESCU
Suffix:
Gender:
Credentials:COMMUNITY MIDWIFE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:618 ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55806-1346
Mailing Address - Country:US
Mailing Address - Phone:218-390-9826
Mailing Address - Fax:218-413-9277
Practice Address - Street 1:618 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55806-1346
Practice Address - Country:US
Practice Address - Phone:218-390-9826
Practice Address - Fax:218-413-9277
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-23
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife