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Individual

ROY EA HOPE

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1973 SLOAN PL, #225, MAPLEWOOD, MN 55117-2084
(651) 224-1347
(651) 855-0126
Mailing address
1973 SLOAN PL, #225, MAPLEWOOD, MN 55117-2084
(651) 224-1347
(651) 855-0126

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
26810
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1700299
MEDICA
MN
01
30839000
MEDICAID
WI
01
5T722HO
BLUE CROSS BLUE SHIELD
MN
Enumeration date
06/04/2006
Last updated
07/08/2007
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