Individual
DOMENICK J ROMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4700 WATERS AVE STE 507, SAVANNAH, GA 31404-6220
(912) 350-4750
(912) 350-4751
Mailing address
4700 WATERS AVE STE 507, SAVANNAH, GA 31404-6220
(912) 350-4750
(912) 350-4751
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
070901
GA
207RP1001X
Pulmonary Disease Physician
070901
GA
390200000X
Student in an Organized Health Care Education/Training Program
148977
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003143431A
—
GA
05
—
GA1598
—
SC
01
—
P01289982
RAILROAD MEDICARE
GA
Enumeration date
06/13/2008
Last updated
01/27/2022
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