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General NPI Number Information
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NPI Number | 1588800858
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Entity Type | Organization
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Legal Business Name | ELDERSBURG ARTHRITIS LLC
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Dates
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Enumeration Date | 12/17/2008
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Last Update Date | 09/30/2011
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Provider Practice Location Address
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Address Line | 6190 GEORGETOWN BLVD SUITE 110
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City | ELDERSBURG
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State | MD
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Zip | 21784-6460
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Country | US
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Telephone | 410-795-9700
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Fax | 410-795-7500
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Provider Business Mailing Address
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Address Line | 6190 GEORGETOWN BLVD SUITE 110
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City | ELDERSBURG
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State | MD
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Zip | 21784-6460
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Country | US
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Telephone | 410-795-9700
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Fax | 410-795-7500
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. FLORIN IOAN NICULESCU
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Credential | M.D.
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Telephone | 410-795-9700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | D0057783
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License Number State | MD
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