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General NPI Number Information
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NPI Number | 1811333693
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Entity Type | Individual
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Provider Name | MELISSA ROMERO M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/20/2013
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Last Update Date | 06/05/2024
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Provider Practice Location Address
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Address Line | 6052 N 59TH AVE
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City | GLENDALE
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State | AZ
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Zip | 85301-7709
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Country | US
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Telephone | 480-618-0176
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 746093
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City | ATLANTA
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State | GA
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Zip | 30374-6093
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Country | US
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Telephone | 312-733-9730
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 52853
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License Number State | AZ
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