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General NPI Number Information
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NPI Number | 1891973640
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Entity Type | Organization
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Legal Business Name | WILLIAM PAUL ROMAN JR
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Dates
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Enumeration Date | 02/04/2008
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Last Update Date | 05/24/2013
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Provider Practice Location Address
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Address Line | 2308 N ROOSEVELT RD
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City | VALPARAISO
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State | IN
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Zip | 46383-2773
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Country | US
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Telephone | 219-464-9588
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Fax | 219-462-4470
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Provider Business Mailing Address
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Address Line | 2308 N ROOSEVELT RD
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City | VALPARAISO
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State | IN
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Zip | 46383-2773
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Country | US
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Telephone | 219-464-9588
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Fax | 219-462-4470
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Authorized Official
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Title or Position | OWNER
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Name | DR. WILLIAM PAUL ROMAN JR.
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Credential | D.P.M.
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Telephone | 219-464-9588
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 07001033A
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License Number State | IN
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