Healthcare Provider Details

I. General information

NPI: 1245291855
Provider Name (Legal Business Name): MIRCEA C TODOR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: MIRCEA TODOR

II. Dates (important events)

Enumeration Date: 03/31/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7250 PARKWAY DR STE 500
HANOVER MD
21076-1343
US

IV. Provider business mailing address

7250 PARKWAY DR STE 500
HANOVER MD
21076-1343
US

V. Phone/Fax

Practice location:
  • Phone: 443-949-0814
  • Fax:
Mailing address:
  • Phone: 443-949-0814
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberD54352
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: