Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MD425001 | PA |
N | 111NI0900X | Internist | MD425001 | PA |
Y | 207RN0300X | Nephrologist | MD425001 | PA |
NPI | 1013982065 |
---|---|
Provider Name | Dr. Ion D. Bucaloiu |
First Address | Danville, PA 17822-3034 |
Second Address | Danville, PA 17822-1401 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2006 |
Last Update Date | 12/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
101095450 | (05) | PA |
I14282 | (02) |