Provider Demographics
NPI:1497745418
Name:ROYAL, STEPHEN H (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:H
Last Name:ROYAL
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 1:2000 PERIMETER PARK DR STE 200
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-8442
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2610 N ELM ST
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28358-3011
Practice Address - Country:US
Practice Address - Phone:910-671-6177
Practice Address - Fax:910-671-6175
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-21
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC39989207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC73755OtherBLUE CROSS BLUE SHIELD
NC8973755Medicaid
NC8973755Medicaid
NC73755OtherBLUE CROSS BLUE SHIELD