Individual
ROMAN O PRAVAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
800 OSTRUM ST STE 100, FOUNTAIN HILL, PA 18015-1010
(484) 526-3010
(484) 526-3591
Mailing address
800 OSTRUM ST STE 100, FOUNTAIN HILL, PA 18015-1010
(484) 526-3010
(484) 526-3591
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD444521
PA
207W00000X
Ophthalmology Physician
ME94998
FL
207WX0107X
Retina Specialist (Ophthalmology) Physician
MD444521
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102724414-0001
—
PA
05
—
276217000
—
FL
Enumeration date
05/09/2006
Last updated
07/21/2022
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