Provider Demographics
NPI:1194723817
Name:ROMAY, MICHAEL M (DC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:M
Last Name:ROMAY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4470 HIGHWAY 95
Mailing Address - Street 2:SUITE 9
Mailing Address - City:FORT MOHAVE
Mailing Address - State:AZ
Mailing Address - Zip Code:86426-9101
Mailing Address - Country:US
Mailing Address - Phone:928-758-9444
Mailing Address - Fax:928-758-7035
Practice Address - Street 1:4470 HIGHWAY 95
Practice Address - Street 2:SUITE 9
Practice Address - City:FORT MOHAVE
Practice Address - State:AZ
Practice Address - Zip Code:86426-9101
Practice Address - Country:US
Practice Address - Phone:928-758-9444
Practice Address - Fax:928-758-7035
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-07
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZAZ4137111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0237310OtherBLUE CROSS BLUE SHIELD
AZ23084137OtherSTATE WORKERS COMPENSATIO
AZT63134Medicare UPIN