Healthcare Provider Details

I. General information

NPI: 1528420718
Provider Name (Legal Business Name): ROMANY REDMAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2016
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

427 12TH ST
PLUMMER ID
83851-4000
US

IV. Provider business mailing address

PO BOX 649
FORT DEFIANCE AZ
86504-0649
US

V. Phone/Fax

Practice location:
  • Phone: 208-686-1931
  • Fax: 208-686-5133
Mailing address:
  • Phone: 928-729-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberM-17687
License Number StateID
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberM-17687
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: