Individual
DR. MARK ELLIOTT ROMANOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 BLYTHE BLVD, CHARLOTTE, NC 28203-5812
(704) 355-2372
(704) 355-6692
Mailing address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
(336) 716-3202
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
29428
SC
207L00000X
Anesthesiology Physician
Primary
36588
NC
207LP2900X
Pain Medicine (Anesthesiology) Physician
29428
SC
207LP2900X
Pain Medicine (Anesthesiology) Physician
36588
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8973044
—
NC
05
—
N36588
—
SC
Enumeration date
10/14/2005
Last updated
08/02/2018
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