Individual
DR. TERRY MARK ROMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
123 HOSPITAL DR, SUITE 1008, WATERTOWN, WI 53098-3331
(920) 206-6500
(920) 261-4013
Mailing address
123 HOSPITAL DR, SUITE 1008, WATERTOWN, WI 53098-3331
(920) 206-6500
(920) 261-4013
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
54555-021
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1083895312
—
WI
Enumeration date
11/15/2007
Last updated
08/29/2013
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