Roman, Demetrius
Roman, Demetrius is an sole proprietor health care provider with primary practice located at 1580 Phoenix Blvd Ste 200 , Atlanta GA 30349-5187. He recently has only one registered license in Behavioral Health & Social Service Providers / Family, which is considered as his primary health care specialty. Roman, Demetrius can be contacted via phone (770) 282-0389.Contact Information
Primary practice address
1580 Phoenix Blvd Ste 200
Atlanta GA 30349-5187
Phone: (770) 282-0389
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Family | 103TF0000X | 06211979 | Georgia |
Profile Details
| NPI number | 1811474125 |
|---|---|
| LBN Legal business name | Roman, Demetrius |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 19th, 2018 |
| Last updated | Jul 19th, 2018 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1811474125 | NPPES |
| Georgia | MEDICAID | 00320566A |
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