Provider Demographics
NPI:1851348932
Name:ROMICK, CHARLES A (MD)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:A
Last Name:ROMICK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 21530
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89721-1530
Mailing Address - Country:US
Mailing Address - Phone:775-884-2455
Mailing Address - Fax:775-884-0345
Practice Address - Street 1:2205 GLENDALE AVE
Practice Address - Street 2:#131
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89431-5511
Practice Address - Country:US
Practice Address - Phone:775-331-3361
Practice Address - Fax:775-331-4719
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV5783207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV104241Medicare PIN
NVC95422Medicare UPIN