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NPI Code Detail

MEDICARE: CHARLES P. ROMAN D.O. PC

MEDICARE: CHARLES P. ROMAN D.O. PC
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
1207Q00000XFamily Medicine Physician
2207R00000XInternal Medicine Physician

General Provider Information

NPI Number : 1396853388
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHARLES P. ROMAN D.O. PC
Provider Business Mailing Address
First Line : 4519 WOODRUFF RD
Second Line : SUITE 4
City : COLUMBUS
State : GA
Zip : 31904-6011
Country : US
Telephone Number : 706-653-2255
Fax Number : 706-653-2329
Provider Business Practice Location Address
First Line : 2737 WARM SPRINGS RD
Second Line : SUITE B & C
City : COLUMBUS
State : GA
Zip : 31904-6859
Country : US
Telephone Number : 706-653-2255
Fax Number : 706-653-2329
Authorized Official
Title or Position : CEO
Name : DR. CHARLES P. ROMAN
Credential : D.O.
Telephone Number : 706-653-2255
Provider Enumeration Date : 08/29/2006
Last Update Date : 09/26/2012

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