Provider Demographics
NPI:1669794673
Name:ROMESBURG, SCOTT E JR
Entity type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:E
Last Name:ROMESBURG
Suffix:JR
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 1:8538 N TRYON ST
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262-3421
Mailing Address - Country:US
Mailing Address - Phone:704-547-8551
Mailing Address - Fax:704-547-8663
Practice Address - Street 1:8538 N TRYON ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-3421
Practice Address - Country:US
Practice Address - Phone:704-547-8551
Practice Address - Fax:704-547-8663
Is Sole Proprietor?:No
Enumeration Date:2010-02-17
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16131183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist