Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 96-01280 | NC |
NPI | 1003808403 |
---|---|
Provider Name | Dr. Lucia Criveanu |
First Address | Burnsville, NC 28714-9010 |
Second Address | Burnsville, NC 28714-9010 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2005 |
Last Update Date | 13/01/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
25769 | BCBS (01) | NC |
8925769 | (05) | NC |
A60115 | (02) | NC |