Healthcare Provider Details

I. General information

NPI: 1467209791
Provider Name (Legal Business Name): IOANA FUGARU MD, MSC, FRCSC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2024
Last Update Date: 11/25/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 BURNET AVENUE CINCINNATI CHILDREN'S HOSPITAL MEDICAL CENTER
CINCINNATI OH
45229
US

IV. Provider business mailing address

1515 AVENUE PRUD'HOMME
MONTREAL QUEBEC
H4A 3H1
CA

V. Phone/Fax

Practice location:
  • Phone: 513-636-4975
  • Fax: 513-636-6753
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number35.149931
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code2088P0231X
TaxonomyPediatric Urology Physician
License Number35.149931
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: