Healthcare Provider Details

I. General information

NPI: 1043266190
Provider Name (Legal Business Name): CIPRIAN CRISMARU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 02/26/2024
Certification Date: 02/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

799 FARSON ST
BELPRE OH
45714-1082
US

IV. Provider business mailing address

77 W HIAWATHA DR
POWELL OH
43065-5107
US

V. Phone/Fax

Practice location:
  • Phone: 740-401-1150
  • Fax: 740-401-1155
Mailing address:
  • Phone: 901-240-1362
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number38901
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number35.139406
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: