Provider Demographics
NPI:1700034766
Name:NEDELCOVICIU, RADU ALEXANDRU (MD)
Entity Type:Individual
Prefix:DR
First Name:RADU
Middle Name:ALEXANDRU
Last Name:NEDELCOVICIU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1100 WALNUT ST
Mailing Address - Street 2:FL 5
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-4944
Mailing Address - Country:US
Mailing Address - Phone:302-674-3970
Mailing Address - Fax:302-672-2350
Practice Address - Street 1:724 S NEW ST
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-3540
Practice Address - Country:US
Practice Address - Phone:302-674-4070
Practice Address - Fax:302-672-2315
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-03
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT 189899208600000X
PAMD444229208600000X
DEC1-0011143208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty