MEDICARE: GARY DEAN ROYE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	MD09826	RI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1912905969
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GARY DEAN ROYE MD

Provider Business Mailing Address
First Line	:	PO BOX 16149
Second Line	:
City	:	RUMFORD
State	:	RI
Zip	:	02916-0697
Country	:	US
Telephone Number	:	401-453-9625
Fax Number	:	401-435-7069

Provider Business Practice Location Address
First Line	:	195 COLLYER ST STE 302
Second Line	:
City	:	PROVIDENCE
State	:	RI
Zip	:	02904-1869
Country	:	US
Telephone Number	:	401-793-5708
Fax Number	:	401-793-5171

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/13/2005
Last Update Date	:	01/29/2020

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Directions to “ GARY DEAN ROYE MD” Practice Location

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