Individual
DR. NICHOLAS ORDUNO ROMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Contact information
Practice address
101 CIVIC CENTER LN, LAKE HAVASU CITY, AZ 86403-5607
(928) 453-3771
Mailing address
101 CIVIC CENTER LN, LAKE HAVASU CITY, AZ 86403-5607
(928) 453-3771
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
81951
AZ
2085R0001X
Radiation Oncology Physician
Primary
48773
AZ
2085R0001X
Radiation Oncology Physician
P3430
TX
Other
Enumeration date
07/02/2007
Last updated
04/30/2014
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