Provider Demographics
NPI:1679532055
Name:ROMAIN, ROLANDE C (MD)
Entity type:Individual
Prefix:DR
First Name:ROLANDE
Middle Name:C
Last Name:ROMAIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3030 SENNA DR
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-6726
Mailing Address - Country:US
Mailing Address - Phone:704-844-8971
Mailing Address - Fax:704-844-8972
Practice Address - Street 1:3030 SENNA DR
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-6726
Practice Address - Country:US
Practice Address - Phone:704-844-8971
Practice Address - Fax:704-844-8972
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC25646208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89138FEMedicaid
NCD62757Medicare UPIN