Provider Demographics
NPI:1396965232
Name:GRAMATOVICI, MIRELA (MD)
Entity type:Individual
Prefix:DR
First Name:MIRELA
Middle Name:
Last Name:GRAMATOVICI
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 1:245 EVERGREEN DR
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:PA
Mailing Address - Zip Code:16323-1811
Mailing Address - Country:US
Mailing Address - Phone:814-432-2741
Mailing Address - Fax:
Practice Address - Street 1:245 EVERGREEN DR
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:PA
Practice Address - Zip Code:16323-1811
Practice Address - Country:US
Practice Address - Phone:814-432-2741
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-048335-L207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAF50435Medicare UPIN