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NPI Code Detail

MEDICARE: FARID ROMAN M.D.

MEDICARE: FARID ROMAN 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
1207RE0101XEndocrinology, Diabetes & Metabolism Physician36790TN
2207RE0101XEndocrinology, Diabetes & Metabolism Physician036.127376IL
3207RE0101XEndocrinology, Diabetes & Metabolism Physician2011000768MO

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00120072OTHERMEDICARE RAILROAD

General Provider Information

NPI Number : 1851366355
Entity Type Code : Individual
Provider Name (Legal Business Name) : FARID ROMAN M.D.
Provider Business Mailing Address
First Line : 11155 DUNN RD STE 109N
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63136-6148
Country : US
Telephone Number : 314-953-8799
Fax Number : 314-953-8798
Provider Business Practice Location Address
First Line : 11155 DUNN RD STE 109N
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63136-6148
Country : US
Telephone Number : 314-953-8799
Fax Number : 314-953-8798
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2006
Last Update Date : 01/14/2022

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Practice Fax:
1669673653 — DR. ANNE REBECCA SEYER M.D.
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1134432479 — SUPRAJA REDDY REDDY REDDY M.D.
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1033498266 — DR. RABIA ASGHAR M.D.
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Directions to “ FARID ROMAN M.D.” Practice Location

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