Individual
PRAVEEN ROY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2841 DEBARR RD STE 50, ANCHORAGE, AK 99508-2945
(907) 276-2811
(907) 276-2810
Mailing address
2841 DEBARR RD STE 50, ANCHORAGE, AK 99508-2945
(907) 276-2811
(907) 276-2810
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
2006017171
MO
207RG0100X
Gastroenterology Physician
Primary
55751
WI
207RG0100X
Gastroenterology Physician
MD.203593
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00531049
—
MS
05
—
201151206
—
MO
01
—
209956
BLUE SHIELD
MO
05
—
2110187
—
LA
01
—
753815
HEALTHLINK
MO
01
—
P00342850
RR MEDICARE
MO
01
—
P00420900
RAILROAD MEDICARE
MO
Enumeration date
07/22/2006
Last updated
09/21/2022
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