MEDICARE: TODD A ROEMMICH M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	57999	GA
2	208000000X	Pediatrics Physician	28215	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	576007863102	OTHER	SC	BCBS

General Provider Information

NPI Number	:	1649316613
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TODD A ROEMMICH M.D.

Provider Business Mailing Address
First Line	:	525 VERDAE BLVD STE 200
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29607-4021
Country	:	US
Telephone Number	:	864-272-0388
Fax Number	:	864-213-9237

Provider Business Practice Location Address
First Line	:	312 HARRISON BRIDGE RD
Second Line	:
City	:	SIMPSONVILLE
State	:	SC
Zip	:	29680-7133
Country	:	US
Telephone Number	:	864-272-0388
Fax Number	:	864-213-9237

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/29/2007
Last Update Date	:	02/14/2019

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Directions to “ TODD A ROEMMICH M.D.” Practice Location

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