Individual
MIRCEA B LIPOVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
222 MEDICAL CIR, MOREHEAD, KY 40351-1179
(606) 783-6500
Mailing address
PO BOX 766, MOREHEAD, KY 40351-0766
(866) 871-7657
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
26831
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000341151
BC/BS INDIVIDUAL PIN NO
KY
05
—
64268311
—
KY
01
—
P00142545
RR MDCR PIN NUMBER
KS
Enumeration date
08/29/2005
Last updated
07/18/2007
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