Provider Demographics
NPI:1417901810
Name:CROITORU, CLAUDIA M (MD)
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:M
Last Name:CROITORU
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:PO BOX 49009
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29649-0001
Mailing Address - Country:US
Mailing Address - Phone:864-223-3070
Mailing Address - Fax:864-223-1396
Practice Address - Street 1:106 VENTURE BLVD
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29306-3805
Practice Address - Country:US
Practice Address - Phone:864-583-3850
Practice Address - Fax:864-583-1405
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2016-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL2201207ZP0105X
SCMD 27370207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX220032633OtherRAILROAD MEDICARE
TX152287201Medicaid
SC273705Medicaid
TX220032633OtherRAILROAD MEDICARE
TXH49639Medicare UPIN
TX8489B8Medicare ID - Type Unspecified