Provider Demographics
NPI:1013956903
Name:ROYEK, ANTHONY BRUNO (MD)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:BRUNO
Last Name:ROYEK
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 1:4750 WATERS AVE STE 302
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31404-6268
Mailing Address - Country:US
Mailing Address - Phone:912-350-5970
Mailing Address - Fax:912-350-3374
Practice Address - Street 1:4750 WATERS AVE
Practice Address - Street 2:SUITE 302
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31404-6200
Practice Address - Country:US
Practice Address - Phone:912-350-5970
Practice Address - Fax:912-350-5976
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA050914207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000936163DMedicaid
GA349824OtherWELLCARE
GA000936163CMedicaid
160056066OtherRAILROAD MEDICARE
582162071007OtherCHAMPUS
GA000936163EMedicaid
GA000936163FMedicaid
GA10065265OtherAMERIGROUP
GA197289OtherBLUE CROSS BLUE SHIELD
SCG50914Medicaid
GA000936163AMedicaid
GA000936163BMedicaid
GA10065265OtherAMERIGROUP
SCG50914Medicaid