Provider Demographics
NPI:1306930805
Name:NICULESCU, FLORIN IOAN (MD PHD)
Entity type:Individual
Prefix:
First Name:FLORIN
Middle Name:IOAN
Last Name:NICULESCU
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6190 GEORGETOWN BLVD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:ELDERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21784
Mailing Address - Country:US
Mailing Address - Phone:410-795-9700
Mailing Address - Fax:410-795-7500
Practice Address - Street 1:6190 GEORGETOWN BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:ELDERSBURG
Practice Address - State:MD
Practice Address - Zip Code:21784
Practice Address - Country:US
Practice Address - Phone:410-795-9700
Practice Address - Fax:410-795-7500
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0057783207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD401768400Medicaid
MDH84237Medicare UPIN
MD882L F989Medicare ID - Type Unspecified