MEDICARE: MICHELE ALANA ROMANO MD

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	207Q00000X	Family Medicine Physician	0101038387	VA

General Provider Information

NPI Number	:	1548200397
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELE ALANA ROMANO MD

Provider Business Mailing Address
First Line	:	8303 CRESTRIDGE RD
Second Line	:
City	:	FAIRFAX STATION
State	:	VA
Zip	:	22039-2311
Country	:	US
Telephone Number	:	703-503-9750
Fax Number	:	703-503-3092

Provider Business Practice Location Address
First Line	:	3998 FAIR RIDGE DR
Second Line	:	SUITE 280
City	:	FAIRFAX
State	:	VA
Zip	:	22033-2907
Country	:	US
Telephone Number	:	703-352-0500
Fax Number	:	703-352-0669

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

Provider Enumeration Date	:	06/08/2006
Last Update Date	:	07/08/2007

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