Provider Demographics
NPI:1366959553
Name:RAZVAN C OPREANU MD PLC
Entity type:Organization
Organization Name:RAZVAN C OPREANU MD PLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICIAN, PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CRISTIN
Authorized Official - Middle Name:RAZVAN
Authorized Official - Last Name:OPREANU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:517-372-0500
Mailing Address - Street 1:737 N GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48906-5160
Mailing Address - Country:US
Mailing Address - Phone:517-372-0500
Mailing Address - Fax:517-482-3220
Practice Address - Street 1:737 N GRAND AVE
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48906-5160
Practice Address - Country:US
Practice Address - Phone:517-372-0500
Practice Address - Fax:517-482-3220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-09
Last Update Date:2018-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI430193541208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1235375585Medicaid