Provider Demographics
NPI:1821164013
Name:JOSEPH, ROY GEORGE (MD)
Entity Type:Individual
Prefix:DR
First Name:ROY
Middle Name:GEORGE
Last Name:JOSEPH
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 1:6001 MONTROSE RD STE 1040
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4874
Mailing Address - Country:US
Mailing Address - Phone:301-943-5082
Mailing Address - Fax:
Practice Address - Street 1:10215 FERNWOOD RD STE 401
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-1191
Practice Address - Country:US
Practice Address - Phone:301-943-5082
Practice Address - Fax:301-312-8986
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101055972208800000X
MDD52172208800000X
DCMD30279208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
006575M92Medicare ID - Type Unspecified
H32246Medicare UPIN