Provider Demographics
NPI:1447474721
Name:ROMANOWSKI, AMI PATEL (MD)
Entity type:Individual
Prefix:
First Name:AMI
Middle Name:PATEL
Last Name:ROMANOWSKI
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:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:704-384-7840
Mailing Address - Fax:704-384-7830
Practice Address - Street 1:201 E MATTHEWS ST
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-5027
Practice Address - Country:US
Practice Address - Phone:704-847-0572
Practice Address - Fax:704-849-9760
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201201318208000000X
OH884422208000000X
PAMD434143208000000X
MA239675208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5921402Medicaid