Provider Demographics
NPI:1265873418
Name:RADULESCU, MIHAIL (MD)
Entity type:Individual
Prefix:
First Name:MIHAIL
Middle Name:
Last Name:RADULESCU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 HILL RD.
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:NY
Mailing Address - Zip Code:13441
Mailing Address - Country:US
Mailing Address - Phone:315-338-7289
Mailing Address - Fax:315-356-0583
Practice Address - Street 1:250 S CRESCENT DR
Practice Address - Street 2:
Practice Address - City:MASON CITY
Practice Address - State:IA
Practice Address - Zip Code:50401-2926
Practice Address - Country:US
Practice Address - Phone:641-494-5210
Practice Address - Fax:641-494-5214
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-16
Last Update Date:2021-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY276388207X00000X
MI4301103884207XS0114X
IA47530207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03950378Medicaid
NY03950378Medicaid