Provider Demographics
NPI:1710998802
Name:SURDULESCU, SEVER CATALIN (MD)
Entity Type:Individual
Prefix:
First Name:SEVER
Middle Name:CATALIN
Last Name:SURDULESCU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 MEDICAL PARK RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-8540
Mailing Address - Country:US
Mailing Address - Phone:704-660-4094
Mailing Address - Fax:704-660-8901
Practice Address - Street 1:170 MEDICAL PARK RD
Practice Address - Street 2:SUITE 103
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-8540
Practice Address - Country:US
Practice Address - Phone:704-660-4094
Practice Address - Fax:704-660-8901
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2265207RS0012X
NC179360207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89127EMMedicaid
NC2280786DMedicare ID - Type Unspecified
NC89127EMMedicaid
G88002Medicare UPIN