Provider Demographics
NPI:1912070574
Name:ROMERO, MICHELLE E (DO)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:E
Last Name:ROMERO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:E
Other - Last Name:FULK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:10524 EUCLID AVE
Mailing Address - Street 2:W.O. WALKER BUILDING, 13TH FLOOR
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44106-2205
Mailing Address - Country:US
Mailing Address - Phone:216-844-8775
Mailing Address - Fax:216-844-5833
Practice Address - Street 1:10524 EUCLID AVE
Practice Address - Street 2:W.O. WALKER BUILDING, 13TH FLOOR
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-2205
Practice Address - Country:US
Practice Address - Phone:216-844-8775
Practice Address - Fax:216-844-5833
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.0101682084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0069325Medicaid
OHP01130824OtherMEDICARE RAILROAD
OH0069325Medicaid
OHH086241Medicare PIN