Basic Information
| Provider Information | |||||||||
| NPI: | 1659865350 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | ROMPCA | ||||||||
| FirstName: | ANNEMARIE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 705 RILEY HOSPITAL DR # 4210 | ||||||||
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| City: | INDIANAPOLIS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 462025109 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3179443774 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1500 EAST MEDICAL CENTER DRIVE | ||||||||
| Address2: | MEDICAL PROFESSIONAL BUILDING D3238 | ||||||||
| City: | ANN ARBOR | ||||||||
| State: | MI | ||||||||
| PostalCode: | 48109 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7346471774 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/18/2018 | ||||||||
| LastUpdateDate: | 06/25/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/25/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 4301115628 | MI | N | Allopathic & Osteopathic Physicians | Pediatrics | 390200000X | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.