Healthcare Provider Details

I. General information

NPI: 1386630671
Provider Name (Legal Business Name): VIORICA MARIA CRISAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2005
Last Update Date: 11/25/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

651 COLLIERS WAY SUITE 406
WEIRTON WV
26062-5053
US

IV. Provider business mailing address

1115 SAINT MELLION DR
PRESTO PA
15142-1009
US

V. Phone/Fax

Practice location:
  • Phone: 304-723-5670
  • Fax: 304-723-5672
Mailing address:
  • Phone: 412-600-1712
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number20464
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: