Provider Demographics
NPI:1790764165
Name:CHIRITESCU, MICSUNICA-ELVIRA (MD)
Entity Type:Individual
Prefix:MRS
First Name:MICSUNICA-ELVIRA
Middle Name:
Last Name:CHIRITESCU
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 1:1091 PEMBERTON HILL RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-4269
Mailing Address - Country:US
Mailing Address - Phone:919-367-2499
Mailing Address - Fax:919-367-3608
Practice Address - Street 1:1091 PEMBERTON HILL RD
Practice Address - Street 2:SUITE 201
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27502-4269
Practice Address - Country:US
Practice Address - Phone:919-367-2499
Practice Address - Fax:919-367-3608
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC49668OtherWELLPATH
NC89129ERMedicaid
NCP00211751OtherRAILROAD MEDICARE
NC129EROtherBLUE CROSS / BLUE SHIELD
NC0007456221OtherAETNA
NC0300074OtherUNITED HEALTHCARE
NC0007456221OtherAETNA
NCP00211751OtherRAILROAD MEDICARE