Provider Demographics
NPI:1497747877
Name:URSACHI, MIHAI-LIVIU C (MD)
Entity Type:Individual
Prefix:
First Name:MIHAI-LIVIU
Middle Name:C
Last Name:URSACHI
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 1:270 PORTLAND WAY SOUTH
Mailing Address - Street 2:
Mailing Address - City:GALION
Mailing Address - State:OH
Mailing Address - Zip Code:44833-0270
Mailing Address - Country:US
Mailing Address - Phone:419-468-0596
Mailing Address - Fax:419-468-0597
Practice Address - Street 1:269 PORTLAND WAY S
Practice Address - Street 2:
Practice Address - City:GALION
Practice Address - State:OH
Practice Address - Zip Code:44833-2312
Practice Address - Country:US
Practice Address - Phone:419-468-0596
Practice Address - Fax:419-468-0597
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS16992207R00000X
OH35087392207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0077751Medicaid
OH0077751Medicaid
MS00124218Medicaid
0124218Medicare ID - Type Unspecified