Roan, Peter G

Roan, Peter G is an individual health care provider with primary practice located at 4424 E Flamingo Ave Suite 300, Nampa ID 83687-9306. He recently has only one registered license in Allopathic & Osteopathic Physicians / Interventional Cardiology, which is considered as his primary health care specialty. Roan, Peter G can be contacted via phone (208) 302-0200.

Contact Information

Primary practice address
4424 E Flamingo Ave Suite 300 Nampa ID 83687-9306
Phone: (208) 302-0200
Fax: (208) 302-0255
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Interventional Cardiology 207RI0011X M6613 Idaho
Allopathic & Osteopathic Physicians / Interventional Cardiology 207RI0011X M-6613 Idaho

Profile Details

NPI number 1326037342
LBN Legal business name Roan, Peter G
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 21st, 2005
Last updated Nov 15th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1326037342 NPPES
Idaho MEDICAID 003895300
Idaho Other 000010149232
Idaho Other P00182709
Idaho Other B3390

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