MEDICARE: AURELIA RADULESCU MD

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	2080B0002X	Pediatric Obesity Medicine Physician	36910	KY
2	208000000X	Pediatrics Physician	36910	KY

General Provider Information

NPI Number	:	1912994419
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AURELIA RADULESCU MD

Provider Business Mailing Address
First Line	:	UNIVERSITY OF KENTUCKY DEPT OF PEDIATRICS
Second Line	:	KENTUCKY CLINIC, ROOM J450
City	:	LEXINGTON
State	:	KY
Zip	:	40536-0001
Country	:	US
Telephone Number	:	859-323-5481
Fax Number	:	859-257-7706

Provider Business Practice Location Address
First Line	:	UK PEDIATRIC SPECIALTY CLINICS 740 S LIMESTONE STE K201
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40536-0001
Country	:	US
Telephone Number	:	859-218-2509
Fax Number	:	859-323-3499

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

Provider Enumeration Date	:	09/30/2005
Last Update Date	:	02/07/2023

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