Provider Demographics
NPI:1326220468
Name:CEBOTARU, VALERIU (MD)
Entity Type:Individual
Prefix:DR
First Name:VALERIU
Middle Name:
Last Name:CEBOTARU
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:PO BOX 64442
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-4442
Mailing Address - Country:US
Mailing Address - Phone:410-328-5720
Mailing Address - Fax:410-328-5685
Practice Address - Street 1:22 S GREENE ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1544
Practice Address - Country:US
Practice Address - Phone:410-328-5720
Practice Address - Fax:410-328-5685
Is Sole Proprietor?:No
Enumeration Date:2007-11-30
Last Update Date:2015-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD67271207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDS062-0567OtherCAREFIRST BC/BS
MD017393200Medicaid
MD413187800Medicaid
MDS062-0567OtherCAREFIRST BC/BS
MD196518ZABUMedicare PIN
MD133316ZA0TMedicare PIN