Provider Demographics
NPI:1568024487
Name:ROY, ANDREW RUSSELL (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:RUSSELL
Last Name:ROY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:UNIVERSITY OF NORTH DAKOTA SMHS DEPARTMENT OF SURGERY
Mailing Address - Street 2:1301 N COLUMBIA ROAD, STOP 9037
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58202-9037
Mailing Address - Country:US
Mailing Address - Phone:701-293-4151
Mailing Address - Fax:701-293-4148
Practice Address - Street 1:UNIVERSITY OF NORTH DAKOTA SMHS DEPARTMENT OF SURGERY
Practice Address - Street 2:1301 N COLUMBIA ROAD, STOP 9037
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58202-9037
Practice Address - Country:US
Practice Address - Phone:701-293-4151
Practice Address - Fax:701-293-4148
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-01
Last Update Date:2019-07-01
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Provider Licenses
StateLicense IDTaxonomies
NDRL15780208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery