Provider Demographics
NPI:1770580045
Name:ROY, PATRICIA J (DO)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:J
Last Name:ROY
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:1864 LAKESHORE DR
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49441-1607
Mailing Address - Country:US
Mailing Address - Phone:231-755-1628
Mailing Address - Fax:231-755-5279
Practice Address - Street 1:1864 LAKESHORE DR
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49441-1607
Practice Address - Country:US
Practice Address - Phone:231-755-1628
Practice Address - Fax:231-755-5279
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2022-02-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI5101008446207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0156100264OtherBCBS
MI2607827/11Medicaid
MI2607827/11Medicaid
E26507Medicare UPIN