Provider Demographics
NPI:1225076656
Name:HOPE, ROY EA (MD)
Entity Type:Individual
Prefix:
First Name:ROY
Middle Name:EA
Last Name:HOPE
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 1:1973 SLOAN PL
Mailing Address - Street 2:#225
Mailing Address - City:MAPLEWOOD
Mailing Address - State:MN
Mailing Address - Zip Code:55117-2084
Mailing Address - Country:US
Mailing Address - Phone:651-224-1347
Mailing Address - Fax:651-855-0126
Practice Address - Street 1:1973 SLOAN PL
Practice Address - Street 2:#225
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55117-2084
Practice Address - Country:US
Practice Address - Phone:651-224-1347
Practice Address - Fax:651-855-0126
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN26810208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN5T722HOOtherBLUE CROSS BLUE SHIELD
MN1700299OtherMEDICA
WI30839000OtherMEDICAID
MN5T722HOOtherBLUE CROSS BLUE SHIELD