Provider Demographics
NPI:1558473801
Name:NEGULESCU, MIHAELA OLIVIA (MD)
Entity Type:Individual
Prefix:
First Name:MIHAELA
Middle Name:OLIVIA
Last Name:NEGULESCU
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 1:88 NORWICH NEW LONDON TPKE
Mailing Address - Street 2:
Mailing Address - City:UNCASVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06382-2518
Mailing Address - Country:US
Mailing Address - Phone:860-367-0087
Mailing Address - Fax:
Practice Address - Street 1:88 NORWICH NEW LONDON TPKE
Practice Address - Street 2:
Practice Address - City:UNCASVILLE
Practice Address - State:CT
Practice Address - Zip Code:06382-2518
Practice Address - Country:US
Practice Address - Phone:860-367-0087
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2012-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT038999207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT038999OtherLICENSE
2V6467OtherHEALTHNET
010038999CT02OtherANTHEM BCBS
110009466Medicare ID - Type Unspecified
CT038999OtherLICENSE