Individual
DR. EDWIN ROMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1009 BROAD ST, SUITE 1, MONTOURSVILLE, PA 17754-2509
(570) 368-8389
(570) 368-8391
Mailing address
1009 BROAD ST, SUITE 1, MONTOURSVILLE, PA 17754-2509
(570) 368-8389
(570) 368-8391
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
MD063687L
PA
208100000X
Physical Medicine & Rehabilitation Physician
Primary
MD063687L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0016591210002
—
PA
01
—
2378143
UNITEDHEALTHCARE
PA
01
—
50054359
CAPITAL BLUE CROSS
PA
01
—
804291
FIRST PRIORITY HEALTH
PA
01
—
897668
AETNA
PA
01
—
969730
HIGHMARK BLUE SHIELD
PA
01
—
G56772
HEALTHAMERICA
PA
Enumeration date
03/09/2006
Last updated
07/15/2019
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