Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | 49642 | WI |
NPI | 1104873371 |
---|---|
Provider Name | Mihai C Teodorescu |
First Address | Middleton, WI 53562-5531 |
Second Address | Madison, WI 53705-3644 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2006 |
Last Update Date | 26/01/2021 |