Provider Demographics
NPI:1457581589
Name:SOLANO, ROY (MD)
Entity Type:Individual
Prefix:DR
First Name:ROY
Middle Name:
Last Name:SOLANO
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:PO BOX 100
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48068-0100
Mailing Address - Country:US
Mailing Address - Phone:248-849-3137
Mailing Address - Fax:248-849-2052
Practice Address - Street 1:44405 WOODWARD AVE
Practice Address - Street 2:ATTN: EMERGENCY DEPARTMENT ADMINISTRATION
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48341-5023
Practice Address - Country:US
Practice Address - Phone:248-758-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-23
Last Update Date:2018-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA207780207P00000X
MI4301094565207P00000X
TXP7210207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX326730402Medicaid
TX315277YLLYMedicaid
TX326730401Medicaid
TXP01336685OtherRAILROAD
TX315277YKN5Medicaid