Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | MD09615 | OR |
NPI | 1023016276 |
---|---|
Provider Name | Richard Romm |
First Address | Eugene, OR 97401-3600 |
Second Address | Eugene, OR 97401-3600 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2005 |
Last Update Date | 01/06/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C93648 | (02) | OR |