Basic Information
| Provider Information | |||||||||
| NPI: | 1699939488 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MANIU | ||||||||
| FirstName: | ADINA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | DUMITRESCU | ||||||||
| OtherFirstName: | ADINA | ||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 250 W PRATT ST | ||||||||
| Address2: | SUITE 880 | ||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212012423 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6672141302 | ||||||||
| FaxNumber: | 4103283379 | ||||||||
| Practice Location | |||||||||
| Address1: | 419 W REDWOOD ST | ||||||||
| Address2: | SUITE 500 | ||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212011734 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6672141300 | ||||||||
| FaxNumber: | 4103282648 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/11/2008 | ||||||||
| LastUpdateDate: | 02/15/2017 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
| NPIDeactivationDate: | |||||||||
| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | |||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 0101246208 | VA | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207V00000X | D0078977 | MD | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 5912954 | 05 | NC | MEDICAID | PAR | 01 | VA | CIGNA | OTHER | PAR | 01 | VA | UNITED HEALTH CARE/MAMSI | OTHER | PAR | 01 | VA | VA PREMIER HEALTH | OTHER | PAR | 01 | VA | AETNA | OTHER | -010 | 01 | VA | TRICARE/CHAMPUS | OTHER | PAR | 01 | VA | VA HEALTH NETWORK | OTHER | 377843 | 01 | VA | ANTHEM BC/BS | OTHER | 10049926 | 01 | VA | SENTARA OPTIMA HEALTH | OTHER | 1699939488 | 05 | VA | MEDICAID | PAR | 01 | VA | USA MANAGED CARE | OTHER | PAR | 01 | VA | FIRST HEALTH COMMERCIAL/SOUTHERN HEALTH/COVENTRY HEALTH | OTHER | 877845 | 01 | VA | ANTHEM BC/BS | OTHER | PAR | 01 | VA | MULTIPLAN | OTHER | 424186000 | 05 | MD | MEDICAID | PAR | 01 | VA | CORVEL/CORCARE | OTHER |