Provider Demographics
NPI:1811986003
Name:PACURAR, TRAIANA DACIANA (MD)
Entity type:Individual
Prefix:
First Name:TRAIANA
Middle Name:DACIANA
Last Name:PACURAR
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:PO BOX 919
Mailing Address - Street 2:
Mailing Address - City:HINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31310-0919
Mailing Address - Country:US
Mailing Address - Phone:912-369-9400
Mailing Address - Fax:
Practice Address - Street 1:586 ISLANDS HIGHWAY
Practice Address - Street 2:
Practice Address - City:MIDWAY
Practice Address - State:GA
Practice Address - Zip Code:31320
Practice Address - Country:US
Practice Address - Phone:912-396-7050
Practice Address - Fax:912-884-4197
Is Sole Proprietor?:No
Enumeration Date:2005-10-19
Last Update Date:2019-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA055131207RA0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0000XAllopathic & Osteopathic PhysiciansInternal MedicineAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA643570982DMedicaid
GAGRP4698Medicare ID - Type UnspecifiedGROUP #
GA08BBRHWMedicare ID - Type Unspecified