Provider Demographics
NPI:1245291855
Name:TODOR, MIRCEA C (MD)
Entity type:Individual
Prefix:DR
First Name:MIRCEA
Middle Name:C
Last Name:TODOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MIRCEA
Other - Middle Name:
Other - Last Name:TODOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7250 PARKWAY DR
Mailing Address - Street 2:STE 500
Mailing Address - City:HANOVER
Mailing Address - State:MD
Mailing Address - Zip Code:21076-1343
Mailing Address - Country:US
Mailing Address - Phone:443-949-0814
Mailing Address - Fax:
Practice Address - Street 1:7250 PARKWAY DR STE 500
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:MD
Practice Address - Zip Code:21076-1343
Practice Address - Country:US
Practice Address - Phone:443-949-0814
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD54352208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDCN6601OtherR/R MEDICARE GROUP #
MD110214869OtherR/R MEDICARE PROVIDER #
MD702301400Medicaid
MDKL3307TTMedicare PIN
MDKL0909TTMedicare PIN
MDCN6601OtherR/R MEDICARE GROUP #
MD110214869OtherR/R MEDICARE PROVIDER #