Individual
ROMEO PIUS MASSOUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 MEDICAL CENTER BLVD, LAWRENCEVILLE, GA 30045-7694
(678) 442-3290
(678) 442-2733
Mailing address
PO BOX 742616, ATLANTA, GA 30374-2616
(770) 219-8420
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
49990
GA
2086S0102X
Surgical Critical Care Physician
Primary
49990
GA
2086S0127X
Trauma Surgery Physician
49990
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000909433A
—
GA
01
—
P00262449
RAILROAD MEDICARE
GA
Enumeration date
01/11/2007
Last updated
11/09/2020
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