Healthcare Provider Details

I. General information

NPI: 1114181450
Provider Name (Legal Business Name): ANDREI COCIERU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2008
Last Update Date: 10/17/2024
Certification Date: 10/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 HARRODSBURG RD STE B355
LEXINGTON KY
40504-3747
US

IV. Provider business mailing address

PO BOX 936
LONDON KY
40743-0936
US

V. Phone/Fax

Practice location:
  • Phone: 859-276-5262
  • Fax: 859-277-6509
Mailing address:
  • Phone: 606-330-7835
  • Fax: 606-330-7825

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberTP510
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number35121481
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: