Provider Demographics
NPI:1386685816
Name:ROY, DAVID (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:ROY
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 1:607 WASHINGTON HWY
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:VT
Mailing Address - Zip Code:05661-8652
Mailing Address - Country:US
Mailing Address - Phone:802-888-6001
Mailing Address - Fax:
Practice Address - Street 1:609 WASHINGTON HWY
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:VT
Practice Address - Zip Code:05661-8652
Practice Address - Country:US
Practice Address - Phone:802-888-5688
Practice Address - Fax:802-888-6040
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2018-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT042-0007251207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT00006643OtherBCBS
VI080103404OtherTRAVELERS MEDICARE
VT0006643Medicaid
VI080103404OtherTRAVELERS MEDICARE
VT00006643OtherBCBS