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Individual

FELICIA IVASCU

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3535 W 13 MILE RD, 607, ROYAL OAK, MI 48073
(248) 288-1130
(248) 288-5931
Mailing address
3535 W 13 MILE RD, 607, ROYAL OAK, MI 48073
(248) 288-1130
(248) 288-5931

Taxonomy

Speciality
Code
Description
License number
State
2086S0102X
Surgical Critical Care Physician
Primary
FI076031
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
061807327
TAX IDENTIFICATION
MI
Enumeration date
03/08/2007
Last updated
01/19/2017
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