Provider Demographics
NPI:1962450056
Name:MARINESCU, GHEORGHE N (MD)
Entity Type:Individual
Prefix:
First Name:GHEORGHE
Middle Name:N
Last Name:MARINESCU
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 1:45555 WOODWARD AVE
Mailing Address - Street 2:SUITE 502
Mailing Address - City:PONTIAC
Mailing Address - State:MI
Mailing Address - Zip Code:48341-5007
Mailing Address - Country:US
Mailing Address - Phone:248-858-3938
Mailing Address - Fax:248-858-3491
Practice Address - Street 1:45555 WOODWARD AVE
Practice Address - Street 2:SUITE 502
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48341-5007
Practice Address - Country:US
Practice Address - Phone:248-858-3938
Practice Address - Fax:248-858-3491
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2008-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301045944207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MID72614Medicare UPIN
MI0M84560Medicare PIN