MEDICARE: DR. RAYME L. ROMANIK 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	209800000X	Legal Medicine (M.D./D.O.) Physician	79-56	NM

General Provider Information

NPI Number	:	1346351988
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAYME L. ROMANIK M.D.

Provider Business Mailing Address
First Line	:	5536 OVERLOOK DR NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87111-1881
Country	:	US
Telephone Number	:	505-841-5729
Fax Number	:	505-841-5657

Provider Business Practice Location Address
First Line	:	3121 AMHERST DR NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87107-4807
Country	:	US
Telephone Number	:	505-841-5729
Fax Number	:	505-841-5657

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

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	07/09/2007

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