Healthcare Provider Details

I. General information

NPI: 1811903974
Provider Name (Legal Business Name): MICHAEL C ROYER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

WALTER REED ARMY MEDICAL CTR 6900 GEORGIA AVE NW
WASHINGTON DC
20307-0001
US

IV. Provider business mailing address

306 12TH ST NE
WASHINGTON DC
20002-6320
US

V. Phone/Fax

Practice location:
  • Phone: 202-782-3520
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZD0900X
TaxonomyDermatopathology (Pathology) Physician
License Number36008
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: