Provider Demographics
NPI:1740313329
Name:ROMZEK, MARK ROBERT (D,O,)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:ROBERT
Last Name:ROMZEK
Suffix:
Gender:M
Credentials:D,O,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1331 BIRCH PARK RDG
Mailing Address - Street 2:
Mailing Address - City:HOULTON
Mailing Address - State:WI
Mailing Address - Zip Code:54082-2411
Mailing Address - Country:US
Mailing Address - Phone:608-632-1051
Mailing Address - Fax:
Practice Address - Street 1:1331 BIRCH PARK RDG
Practice Address - Street 2:
Practice Address - City:HOULTON
Practice Address - State:WI
Practice Address - Zip Code:54082-2411
Practice Address - Country:US
Practice Address - Phone:608-632-1051
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL19289207X00000X
IL036.163848207X00000X
WI52260207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery