Individual
RADU H TEODORESCU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10202 SE 32ND AVE, STE 701, MILWAUKIE, OR 97222-3610
(503) 513-1410
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
04-32929
KS
2084P0800X
Psychiatry Physician
2003008020
MO
2084P0800X
Psychiatry Physician
Primary
MD179433
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1050505001
—
AR
01
—
106983
MEDICARE PTAN
KS
05
—
200540710A
—
KS
05
—
209023803
—
MO
05
—
500715955
—
OR
01
—
P00056349
TRAVELERS MEDICARE
—
01
—
P01765514
RR MEDICARE (PH&S)-PMG
OR
Enumeration date
01/11/2006
Last updated
02/09/2017
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