Provider Demographics
NPI:1922292085
Name:ROY, BRIAN RENE (DO)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:RENE
Last Name:ROY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:803 OSTRUM ST.
Mailing Address - Street 2:EMERGENCY MEDICINE DEPARTMENT
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18015
Mailing Address - Country:US
Mailing Address - Phone:610-954-4903
Mailing Address - Fax:610-954-2153
Practice Address - Street 1:803 OSTRUM ST.
Practice Address - Street 2:EMERGENCY MEDICINE DEPARTMENT
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18015
Practice Address - Country:US
Practice Address - Phone:610-954-4903
Practice Address - Fax:610-954-2153
Is Sole Proprietor?:No
Enumeration Date:2007-08-31
Last Update Date:2007-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS013847207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine