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General NPI Number Information
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NPI Number | 1376712414
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Entity Type | Organization
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Legal Business Name | MINERVA HEALTHCARE, PC
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Dates
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Enumeration Date | 02/22/2008
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Last Update Date | 02/28/2008
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Provider Practice Location Address
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Address Line | 8501 WILLIAMS AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19150-1912
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Country | US
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Telephone | 215-242-2256
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Fax | 215-242-8833
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Provider Business Mailing Address
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Address Line | 8501 WILLIAMS AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19150-1912
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Country | US
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Telephone | 215-242-2256
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Fax | 215-242-8833
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. MARIA MILCU
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Credential | MD
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Telephone | 215-242-2256
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | MD043486-L
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License Number State | PA
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