Provider Demographics
NPI:1033159231
Name:BISCOVEANU, MIHAELA (MD)
Entity Type:Individual
Prefix:
First Name:MIHAELA
Middle Name:
Last Name:BISCOVEANU
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 1:9501 ROOSEVELT BLVD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19114-1025
Mailing Address - Country:US
Mailing Address - Phone:215-969-9511
Mailing Address - Fax:215-969-9512
Practice Address - Street 1:9501 ROOSEVELT BLVD
Practice Address - Street 2:SUITE 400
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19114-1025
Practice Address - Country:US
Practice Address - Phone:215-969-9511
Practice Address - Fax:215-969-9512
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2016-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD065835L207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA518850OtherBLUE SHIELD
H12764Medicare UPIN
PA518850OtherBLUE SHIELD