Provider Demographics
NPI:1922387448
Name:ROYAL VICTORIA HOSPITAL
Entity Type:Organization
Organization Name:ROYAL VICTORIA HOSPITAL
Other - Org Name:KING SAUD UNIVERSITY
Other - Org Type:Other Name
Authorized Official - Title/Position:PROGRAM DIRECTOR HEPATOBILIARY
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:METRAKOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:514-843-1600
Mailing Address - Street 1:687 PINE AVE
Mailing Address - Street 2:S10.26
Mailing Address - City:MONTREAL
Mailing Address - State:QC
Mailing Address - Zip Code:H3A1A1
Mailing Address - Country:CA
Mailing Address - Phone:514-834-1934
Mailing Address - Fax:514-843-1503
Practice Address - Street 1:687 PINE AVE
Practice Address - Street 2:S10.26
Practice Address - City:MONTREAL
Practice Address - State:QC
Practice Address - Zip Code:H3A1A1
Practice Address - Country:CA
Practice Address - Phone:514-834-1934
Practice Address - Fax:514-843-1503
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-15
Last Update Date:2011-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ09449282N00000X
ZZ11RM0003174284300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No284300000XHospitalsSpecial Hospital