Provider Demographics
NPI:1235109513
Name:MARINESCU, STELIAN (MD)
Entity Type:Individual
Prefix:
First Name:STELIAN
Middle Name:
Last Name:MARINESCU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1193 COPPERWOOD
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48302
Mailing Address - Country:US
Mailing Address - Phone:313-359-3652
Mailing Address - Fax:313-359-3654
Practice Address - Street 1:23100 CHERRY HILL
Practice Address - Street 2:SUITE 5
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124
Practice Address - Country:US
Practice Address - Phone:313-359-3652
Practice Address - Fax:313-359-3654
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301053643207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4344019Medicaid
MI4344019Medicaid
T92173Medicare UPIN