Healthcare Provider Details

I. General information

NPI: 1457690141
Provider Name (Legal Business Name): DAN A CRISTESCU MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2013
Last Update Date: 02/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 PARKSIDE DR SU 200
COLORADO SPRINGS CO
80910-3131
US

IV. Provider business mailing address

215 PARKSIDE DR SU 200
COLORADO SPRINGS CO
80910-3131
US

V. Phone/Fax

Practice location:
  • Phone: 719-475-9613
  • Fax: 719-475-9539
Mailing address:
  • Phone: 719-475-9613
  • Fax: 719-475-9539

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number52051
License Number StateCO

VIII. Authorized Official

Name: DR. DAN AUREL CRISTESCU
Title or Position: OWNER
Credential: M.D.
Phone: 401-402-0064