Provider Demographics
NPI:1306936414
Name:ROUMANI, SAMI A (MD)
Entity type:Individual
Prefix:DR
First Name:SAMI
Middle Name:A
Last Name:ROUMANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3046 S 13TH ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53215-3826
Mailing Address - Country:US
Mailing Address - Phone:414-649-9696
Mailing Address - Fax:414-649-9698
Practice Address - Street 1:3046 S 13TH ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53215-3826
Practice Address - Country:US
Practice Address - Phone:414-649-9696
Practice Address - Fax:414-649-9698
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI34275207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI31947200Medicaid
WI391817459012OtherBLUE CROSS BLUE SHEILD
WI391817459012OtherBLUE CROSS BLUE SHEILD