Individual
CAROL ANN ROYER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
611 E. DOUGLAS RD., SUITE 128, MISHAWAKA, IN 46545-1464
(574) 335-6210
(574) 335-6211
Mailing address
PO BOX 8016, SOUTH BEND, IN 46660-8016
(574) 271-7911
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01030119
IN
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
01030119
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100091090B
—
IN
Enumeration date
01/25/2007
Last updated
12/04/2009
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