Provider Demographics
NPI:1588800858
Name:ELDERSBURG ARTHRITIS LLC
Entity Type:Organization
Organization Name:ELDERSBURG ARTHRITIS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:FLORIN
Authorized Official - Middle Name:IOAN
Authorized Official - Last Name:NICULESCU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-795-9700
Mailing Address - Street 1:6190 GEORGETOWN BLVD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:ELDERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21784-6460
Mailing Address - Country:US
Mailing Address - Phone:410-795-9700
Mailing Address - Fax:410-795-7500
Practice Address - Street 1:6190 GEORGETOWN BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:ELDERSBURG
Practice Address - State:MD
Practice Address - Zip Code:21784-6460
Practice Address - Country:US
Practice Address - Phone:410-795-9700
Practice Address - Fax:410-795-7500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-17
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0057783207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDH84237Medicare UPIN