Demetrius Roman, | |
1580 Phoenix Blvd Ste 200, Atlanta, GA 30349-5187 | |
(770) 282-0389 | |
Not Available |
Full Name | Demetrius Roman |
---|---|
Gender | Male |
Speciality | Psychologist - Family |
Location | 1580 Phoenix Blvd Ste 200, Atlanta, Georgia |
Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1811474125 | NPI | - | NPPES |
00320566A | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TF0000X | Psychologist - Family | 06211979 (Georgia) | Primary |
Mailing Address | Practice Location Address |
---|---|
Demetrius Roman, Po Box 962651, Riverdale, GA 30296-6926 Ph: (770) 282-0389 | Demetrius Roman, 1580 Phoenix Blvd Ste 200, Atlanta, GA 30349-5187 Ph: (770) 282-0389 |
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