Basic Information
| Provider Information | |||||||||
| NPI: | 1851348932 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ROMICK | ||||||||
| FirstName: | CHARLES | ||||||||
| MiddleName: | A. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 21530 | ||||||||
| Address2: | |||||||||
| City: | CARSON CITY | ||||||||
| State: | NV | ||||||||
| PostalCode: | 897211530 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7758842455 | ||||||||
| FaxNumber: | 7758840345 | ||||||||
| Practice Location | |||||||||
| Address1: | 2205 GLENDALE AVE | ||||||||
| Address2: | #131 | ||||||||
| City: | SPARKS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 894315511 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7753313361 | ||||||||
| FaxNumber: | 7753314719 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/27/2006 | ||||||||
| LastUpdateDate: | 10/17/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 5783 | NV | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.