Individual
MICHAEL ROY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
22 BRAMHALL ST, PORTLAND, ME 04102
(207) 662-2651
Mailing address
161 MARGINAL WAY, PORTLAND, ME 04101-2438
(207) 773-7964
(207) 773-9073
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
12322
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
243200099
—
ME
Enumeration date
09/20/2006
Last updated
09/05/2018
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