Provider Demographics
NPI:1518932144
Name:STELIAN MARINESCU MD PC
Entity Type:Organization
Organization Name:STELIAN MARINESCU MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER MANAGING AGENT
Authorized Official - Prefix:
Authorized Official - First Name:STELIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MARINESCU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-359-3652
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-17
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301053643207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4344019Medicaid
F92173Medicare UPIN
MI0N31070Medicare PIN