MEDICARE: TRAIANA DACIANA PACURAR 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
1	207RA0000X	Adolescent Medicine (Internal Medicine) Physician	055131	GA

General Provider Information

NPI Number	:	1811986003
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRAIANA DACIANA PACURAR M.D.

Provider Business Mailing Address
First Line	:	PO BOX 919
Second Line	:
City	:	HINESVILLE
State	:	GA
Zip	:	31310-0919
Country	:	US
Telephone Number	:	912-369-9400
Fax Number	:

Provider Business Practice Location Address
First Line	:	586 ISLANDS HIGHWAY
Second Line	:
City	:	MIDWAY
State	:	GA
Zip	:	31320
Country	:	US
Telephone Number	:	912-396-7050
Fax Number	:	912-884-4197

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/19/2005
Last Update Date	:	05/22/2019

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