Provider Demographics
NPI:1942223417
Name:CRINTEA-STOIAN, DIANA G (MD)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:G
Last Name:CRINTEA-STOIAN
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 1:303 E NICOLLET BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-4522
Mailing Address - Country:US
Mailing Address - Phone:952-460-4000
Mailing Address - Fax:952-460-4000
Practice Address - Street 1:303 E NICOLLET BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-4522
Practice Address - Country:US
Practice Address - Phone:952-460-4000
Practice Address - Fax:952-460-4000
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN46698207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND11677Medicaid
MN362K1CROtherBCBS NUMBER
NE41091744413Medicaid
MN04-07330OtherMEDICA NUMBER
MN1030701OtherPREFERRED ONE NUMBER
MN132445OtherUCARE NUMBER
MN106652800Medicaid
MN41091744456537A138OtherCHAMPUS NUMBER
MN106652800Medicaid
MN04-07330OtherMEDICA NUMBER
NE41091744413Medicaid