Individual
IOAN VLAD NICOLESCU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2555 MARVIN RD NE, LACEY, WA 98516-3138
(360) 493-7800
Mailing address
2555 MARVIN RD NE, LACEY, WA 98516-3138
(360) 493-7800
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD60664294
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64133745
—
CO
Enumeration date
07/31/2007
Last updated
07/21/2022
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