Basic Information
| Provider Information | |||||||||
| NPI: | 1942223417 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CRINTEA-STOIAN | ||||||||
| FirstName: | DIANA | ||||||||
| MiddleName: | G. | ||||||||
| NamePrefix: | |||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 303 E NICOLLET BLVD | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | BURNSVILLE | ||||||||
| State: | MN | ||||||||
| PostalCode: | 553374522 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9524604000 | ||||||||
| FaxNumber: | 9524604000 | ||||||||
| Practice Location | |||||||||
| Address1: | 303 E NICOLLET BLVD | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | BURNSVILLE | ||||||||
| State: | MN | ||||||||
| PostalCode: | 553374522 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9524604000 | ||||||||
| FaxNumber: | 9524604000 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/25/2006 | ||||||||
| LastUpdateDate: | 06/21/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 46698 | MN | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 11677 | 05 | ND | MEDICAID | 362K1CR | 01 | MN | BCBS NUMBER | OTHER | 41091744413 | 05 | NE | MEDICAID | 04-07330 | 01 | MN | MEDICA NUMBER | OTHER | 1030701 | 01 | MN | PREFERRED ONE NUMBER | OTHER | 132445 | 01 | MN | UCARE NUMBER | OTHER | 106652800 | 05 | MN | MEDICAID | 41091744456537A138 | 01 | MN | CHAMPUS NUMBER | OTHER |