Healthcare Provider Details

I. General information

NPI: 1760486476
Provider Name (Legal Business Name): ROY L CARMAN III MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2005
Last Update Date: 11/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 WHITE RD SUITE 211
LITTLE SILVER NJ
07739-1166
US

IV. Provider business mailing address

180 WHITE RD SUITE 211
LITTLE SILVER NJ
07739-1166
US

V. Phone/Fax

Practice location:
  • Phone: 732-747-4007
  • Fax: 732-747-8497
Mailing address:
  • Phone: 732-747-4007
  • Fax: 732-747-8497

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25MA03270100
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberMA32701
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: