Individual
MR. MIHAI ILIESIU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
27483 DEQUINDRE RD STE 210, MADISON HEIGHTS, MI 48071-5711
(248) 398-4081
(248) 398-4527
Mailing address
29992 NORTHWESTERN HWY STE C, FARMINGTON HILLS, MI 48334-3292
(248) 851-1430
(248) 851-5182
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
4301094974
MI
207RP1001X
Pulmonary Disease Physician
Primary
4301094974
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1467682443
—
MI
01
—
MI4989684
MEDICARE PTAN
MI
Enumeration date
07/23/2009
Last updated
06/04/2019
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