Provider Demographics
NPI:1245335967
Name:ADANIYA, ROY S (MD)
Entity type:Individual
Prefix:DR
First Name:ROY
Middle Name:S
Last Name:ADANIYA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2903 LAOLA PL
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-1038
Mailing Address - Country:US
Mailing Address - Phone:808-722-9365
Mailing Address - Fax:808-536-2033
Practice Address - Street 1:1905 E HUEBBE PKWY
Practice Address - Street 2:
Practice Address - City:BELOIT
Practice Address - State:WI
Practice Address - Zip Code:53511-1842
Practice Address - Country:US
Practice Address - Phone:608-364-2293
Practice Address - Fax:608-364-5452
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2016-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-1806207RP1001X
MI4301102340207RP1001X, 207RC0200X, 207R00000X
WI54676-20207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HID36071Medicare UPIN
MIM74750392Medicare PIN