Physician Compare National (NPI:1538202437)

HEALTHCARE PROVIDER: IULIANA KETA SELARU M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1538202437
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4981762424
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20081028000028
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SELARU
	Individual professional last name
Provider First Name	IULIANA
	Individual professional first name
Provider Middle Name	KETA
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1999
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	PRIVIA MEDICAL GROUP, LLC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	4385682061
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	967
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	133 DEFENSE HWY
	Group Practice or individual's line 1 address
Marker of address line 2 suppression	Y
	Marker that address as reported may be incomplete
City	ANNAPOLIS
	Group Practice or individual's city
State	MD
	Group Practice or individual's state
Zip Code	214017015
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	210048
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	HOWARD COUNTY GENERAL HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y