Provider Demographics
NPI:1972990026
Name:EL ROMH, DAVID
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:EL ROMH
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 1:6903 THEISEN ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-1987
Mailing Address - Country:US
Mailing Address - Phone:313-896-6399
Mailing Address - Fax:313-397-0858
Practice Address - Street 1:6903 THEISEN ST
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-1987
Practice Address - Country:US
Practice Address - Phone:313-896-6399
Practice Address - Fax:313-397-0858
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-15
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL10077343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)