Provider Demographics
NPI:1164839874
Name:ROMERO, DAVID
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:ROMERO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 N DIVISION ST
Mailing Address - Street 2:UPMC PASSAVANT HOSPITAL
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-3663
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:659 S SALISBURY BLVD
Practice Address - Street 2:SUITE 2
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-5453
Practice Address - Country:US
Practice Address - Phone:410-543-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-14
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD5419363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant