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NPI Code Detail

MEDICARE: DR. PETRE UDREA M.D.

MEDICARE: DR. PETRE UDREA M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084N0400XNeurology Physician35-07-1169-UOH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1245232024
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PETRE UDREA M.D.
Provider Business Mailing Address
First Line : 1975 MIAMISBURG CENTERVILLE RD
Second Line :
City : CENTERVILLE
State : OH
Zip : 45459-3811
Country : US
Telephone Number : 937-439-6186
Fax Number : 937-439-9900
Provider Business Practice Location Address
First Line : 1975 MIAMISBURG CENTERVILLE RD
Second Line :
City : CENTERVILLE
State : OH
Zip : 45459-3811
Country : US
Telephone Number : 937-439-6186
Fax Number : 937-439-9900
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2005
Last Update Date : 06/02/2020

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