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General NPI Number Information
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NPI Number | 1669799458
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Entity Type | Organization
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Legal Business Name | PETER T ROEMER MD
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Dates
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Enumeration Date | 05/03/2010
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Last Update Date | 05/03/2010
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Provider Practice Location Address
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Address Line | 120 STURGES AVE
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City | MANSFIELD
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State | OH
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Zip | 44903-2399
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Country | US
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Telephone | 419-522-2026
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Fax | 419-526-2439
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Provider Business Mailing Address
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Address Line | 120 STURGES AVE
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City | MANSFIELD
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State | OH
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Zip | 44903-2399
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Country | US
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Telephone | 419-522-2026
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Fax | 419-526-2439
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. KATHI SCHROEMER
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Credential |
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Telephone | 419-522-2026
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 35037658
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License Number State | OH
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