Provider Demographics
NPI:1396728903
Name:AKHTAR, ROOMANA (MD)
Entity type:Individual
Prefix:DR
First Name:ROOMANA
Middle Name:
Last Name:AKHTAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26515 AMHEARST CIR
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-8510
Mailing Address - Country:US
Mailing Address - Phone:440-378-1296
Mailing Address - Fax:440-428-1695
Practice Address - Street 1:6770 MAYFIELD RD
Practice Address - Street 2:SUITE 425
Practice Address - City:MAYFIELD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44124-2299
Practice Address - Country:US
Practice Address - Phone:440-312-9041
Practice Address - Fax:440-428-1695
Is Sole Proprietor?:No
Enumeration Date:2005-11-29
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35086027174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHI39579Medicare UPIN
OHAK4167301Medicare ID - Type Unspecified