Provider Demographics
NPI:1457351918
Name:MOREIRA, ROY (MD)
Entity Type:Individual
Prefix:DR
First Name:ROY
Middle Name:
Last Name:MOREIRA
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 1:411 PARKWAY
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-1644
Mailing Address - Country:US
Mailing Address - Phone:336-574-0464
Mailing Address - Fax:336-574-0467
Practice Address - Street 1:411 PARKWAY
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-1644
Practice Address - Country:US
Practice Address - Phone:336-574-0464
Practice Address - Fax:336-574-0467
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-27
Last Update Date:2014-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9400106207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
460480116OtherONE HEALTH
8960651OtherCAROLINA ACCESS
460480116OtherFOCUS BEECH STREET
834787OtherOPTIMUM C
460480116OtherGUARDIAN MEDCOST
460480116OtherHEALTHCARE SAVINGS
460480116OtherPHCS
460480116OtherPRIMARY CARE PHYSICIAN
834787OtherMAMSI
460480116OtherGREAT WEST ONE HEALTH
5981OtherPARTNERS MCA
460480116OtherFIRST HEALTH
4552971OtherAETNA
5981OtherPARTNERS
110242882OtherRRM
460480116OtherCIGNA
NC60651OtherBCBS
NC8960651Medicaid
460480116OtherFIRST HEALTH
NC8960651Medicaid