Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Mark David Roman, PA-C

Individual provider Physician Assistant · NPI 1588692602

Mr. Mark David Roman, PA-C is a Physician Assistant in Dallas, Georgia. Practices as a sole proprietor. Licensed in Florida.

Licensed in
FL
In the registry since
2006
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

225 Mary Wallace Way
Dallas, GA 30157-5054
Phone: (770) 608-3302
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA9101641 (FL)

Record details

NPI number1588692602
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorYes
NPI enumeratedJune 29, 2006
Last updated in NPPESAugust 13, 2018

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