Provider Demographics
NPI:1295912657
Name:ROMA, ANDRES ANIBAL (MD)
Entity type:Individual
Prefix:DR
First Name:ANDRES
Middle Name:ANIBAL
Last Name:ROMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9500 EUCLID AVE
Mailing Address - Street 2:L2
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44195-0001
Mailing Address - Country:US
Mailing Address - Phone:216-445-7016
Mailing Address - Fax:216-636-0890
Practice Address - Street 1:9500 EUCLID AVE
Practice Address - Street 2:L2
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-0001
Practice Address - Country:US
Practice Address - Phone:216-445-7016
Practice Address - Fax:216-636-0890
Is Sole Proprietor?:No
Enumeration Date:2008-01-29
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH095733207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology