Provider Demographics
NPI:1639141344
Name:SORESCU, MUGUREL LUCIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:MUGUREL
Middle Name:LUCIAN
Last Name:SORESCU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 249
Mailing Address - Street 2:
Mailing Address - City:YADKINVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27055-0249
Mailing Address - Country:US
Mailing Address - Phone:336-679-4963
Mailing Address - Fax:336-679-2549
Practice Address - Street 1:1909 W PARK DR
Practice Address - Street 2:
Practice Address - City:N WILKESBORO
Practice Address - State:NC
Practice Address - Zip Code:28659-3564
Practice Address - Country:US
Practice Address - Phone:336-667-1001
Practice Address - Fax:336-667-1422
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2020-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT043471207R00000X
NC200101141207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1302GOtherBCBS OF NC
NC5644913OtherFIRST HEALTH
NC7072327OtherAETNA
NCB1150OtherMEDCOST
NC2110303OtherUNITED HEALTHCARE
NC3934988002OtherCIGNA
NC891302GMedicaid
NC891302GMedicaid
NCH57180Medicare UPIN