Healthcare Provider Details

I. General information

NPI: 1275687865
Provider Name (Legal Business Name): ALEXANDRU COSTIN DINU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 10/04/2022
Certification Date: 10/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2010 W ARLINGTON BLVD
GREENVILLE NC
27834-5779
US

IV. Provider business mailing address

PO BOX 751069
CHARLOTTE NC
28275-1069
US

V. Phone/Fax

Practice location:
  • Phone: 252-847-0617
  • Fax: 252-847-0058
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number49805
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number2017-02037
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: