Provider Demographics
NPI:1245233451
Name:ANGHELESCU, DORALINA L (MD)
Entity Type:Individual
Prefix:DR
First Name:DORALINA
Middle Name:L
Last Name:ANGHELESCU
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 1:262 DANNY THOMAS PLACE., MS 0515
Mailing Address - Street 2:ST. JUDE CHILDREN'S RESEARCH HOSPITAL
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38105-3678
Mailing Address - Country:US
Mailing Address - Phone:901-595-3006
Mailing Address - Fax:901-595-3842
Practice Address - Street 1:262 DANNY THOMAS PLACE., MS 0515
Practice Address - Street 2:ST. JUDE CHILDREN'S RESEARCH HOSPITAL
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38105-3678
Practice Address - Country:US
Practice Address - Phone:901-595-3006
Practice Address - Fax:901-595-3842
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN31175207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR137050001Medicaid
ME422400000Medicaid
LA1560596Medicaid
MT0149526Medicaid
MI104677867Medicaid
MS00120823Medicaid
AL009914170Medicaid
KS200377650AMedicaid
KY64712805Medicaid
AZ796500Medicaid
GA798055310AMedicaid
NE100249678-00Medicaid
MO205026404Medicaid
TN3839898Medicaid
NC7611303Medicaid
IA0528562Medicaid
IN200239740AMedicaid
NE100249678-00Medicaid
IA0528562Medicaid