Provider Demographics
NPI:1497718274
Name:ROEMER, WILLIAM P (PA-C)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:P
Last Name:ROEMER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1240 HUFFMAN MILL RD
Mailing Address - Street 2:PHYSICIAN CARE
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-8700
Mailing Address - Country:US
Mailing Address - Phone:336-570-0344
Mailing Address - Fax:336-570-3045
Practice Address - Street 1:1240 HUFFMAN MILL RD
Practice Address - Street 2:PHYSICIAN CARE
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-8700
Practice Address - Country:US
Practice Address - Phone:336-570-0344
Practice Address - Fax:336-570-3045
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA 2009363A00000X
NC101617363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCE 2275Medicare PIN
FLS76193Medicare UPIN