Provider Demographics
NPI:1003062019
Name:ROME, LEE HOWARD (MD)
Entity Type:Individual
Prefix:
First Name:LEE
Middle Name:HOWARD
Last Name:ROME
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13308 SE 306TH ST
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98092-3279
Mailing Address - Country:US
Mailing Address - Phone:734-476-9993
Mailing Address - Fax:
Practice Address - Street 1:6860 WELLINGTON DR
Practice Address - Street 2:
Practice Address - City:DEXTER
Practice Address - State:MI
Practice Address - Zip Code:48130-2513
Practice Address - Country:US
Practice Address - Phone:734-424-0194
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-09
Last Update Date:2016-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010381442084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry