Provider Demographics
NPI:1912945197
Name:ROY, SANAT KUMAR (MD)
Entity Type:Individual
Prefix:
First Name:SANAT
Middle Name:KUMAR
Last Name:ROY
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 1:2222 S 16TH ST STE 410
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68502-3785
Mailing Address - Country:US
Mailing Address - Phone:402-474-1511
Mailing Address - Fax:402-474-1611
Practice Address - Street 1:2222 S 16TH ST STE 410
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68502-3785
Practice Address - Country:US
Practice Address - Phone:402-474-1511
Practice Address - Fax:402-474-1611
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-02
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE175562084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
03792OtherBCBS PROVIDER
097064Medicare ID - Type Unspecified
E28756Medicare UPIN