Provider Demographics
NPI:1255778742
Name:GEORGIANA GEORGESCU MD PC
Entity type:Organization
Organization Name:GEORGIANA GEORGESCU MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:GEORGESCU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:443-722-6273
Mailing Address - Street 1:4531 N 16TH ST STE 114
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-5344
Mailing Address - Country:US
Mailing Address - Phone:602-324-0422
Mailing Address - Fax:602-266-4477
Practice Address - Street 1:18701 N 67TH AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-7100
Practice Address - Country:US
Practice Address - Phone:602-324-0422
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-24
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ47290207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty