Provider Demographics
NPI:1518189885
Name:ROYSTER, GREENE DONALD IV (MD)
Entity Type:Individual
Prefix:DR
First Name:GREENE
Middle Name:DONALD
Last Name:ROYSTER
Suffix:IV
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:361 HOSPITAL RD STE 333
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-3524
Mailing Address - Country:US
Mailing Address - Phone:949-642-5236
Mailing Address - Fax:
Practice Address - Street 1:361 HOSPITAL RD STE 333
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-3524
Practice Address - Country:US
Practice Address - Phone:949-642-8727
Practice Address - Fax:949-642-5413
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC166960207VE0102X
NC2020-02253207VE0102X
IN01064970A207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology