1225084114 NPI number — DR. ERDULFO ANTONIO ROMERO JR. MD

Table of content: DR. ERDULFO ANTONIO ROMERO JR. MD (NPI 1225084114)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225084114 NPI number — DR. ERDULFO ANTONIO ROMERO JR. MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROMERO
Provider First Name:
ERDULFO
Provider Middle Name:
ANTONIO
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
JR.
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1225084114
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/21/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
WASHINGTON DC VAMC 50 IRVING ST NW
Provider Second Line Business Mailing Address:
F11
Provider Business Mailing Address City Name:
WASHINGTON
Provider Business Mailing Address State Name:
DC
Provider Business Mailing Address Postal Code:
20422-0001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
202-745-8000
Provider Business Mailing Address Fax Number:
202-745-8500

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
WASHINGTON DC VAMC F11
Provider Second Line Business Practice Location Address:
50 IRVING STREET, NW.
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20422-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-745-8000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/25/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  ME82028 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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