Provider Demographics
NPI:1417956830
Name:TUDORICA, MIHAELA (MD)
Entity type:Individual
Prefix:
First Name:MIHAELA
Middle Name:
Last Name:TUDORICA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 GREAT CIRCLE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37228-1317
Mailing Address - Country:US
Mailing Address - Phone:615-284-4672
Mailing Address - Fax:615-284-5752
Practice Address - Street 1:2000 CHURCH ST
Practice Address - Street 2:IP-HOSPITALISTS
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37236-4400
Practice Address - Country:US
Practice Address - Phone:615-284-4672
Practice Address - Fax:615-284-5752
Is Sole Proprietor?:No
Enumeration Date:2005-07-18
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD37266207R00000X
TN37266208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN7143441OtherAETNA
TNP00666335OtherRR MEDICARE
TN4172863OtherBLUE CROSS BLUE SHIELD
TN1507336Medicaid
TN38831102Medicaid
TN38831102Medicaid
TN1507336Medicaid