Dr. Terry Mark Roman
Sports Medicine Orthopaedic Surgeon
123 Hospital Dr Suite 1008
Watertown
, Wisconsin 53098-3331
Dr. Terry Mark Roman
Sports Medicine Orthopaedic Surgeon
123 Hospital Dr Suite 1008
Watertown
, Wisconsin 53098-3331
(920) 261-4013
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About
Features
Specialties
- Sports Medicine Orthopaedic Surgeon
Languages spoken
- English
Location
First Address
- Dr. Terry Mark Roman
- 123 Hospital Dr Suite 1008
- Watertown, WI
- Zip : 53098-3331
- Fax : (920) 261-4013
- Phone : (920) 206-6500
Second Address
- Dr. Terry Mark Roman
- 123 Hospital Dr Suite 1008
- Watertown, WI
- Zip : 53098-3331
- Fax : (920) 261-4013
- Phone : (920) 206-6500
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 54555-021 | WI |
National Provider Identifier
| NPI | 1083895312 |
|---|---|
| Provider Name | Dr. Terry Mark Roman |
| First Address | Watertown, WI 53098-3331 |
| Second Address | Watertown, WI 53098-3331 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 15/11/2007 |
| Last Update Date | 29/08/2013 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 1083895312 | (05) | WI |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.