Individual
DR. TIMOTHY GRAYSON ROYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
3790 30TH ST SW, GRANDVILLE, MI 49418-1602
(800) 600-4096
(800) 606-8839
Mailing address
PO BOX 607, GRANDVILLE, MI 49468-0607
(800) 600-4096
(800) 606-8839
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
6301009353
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0D14689
BLUE CROSS BLUE SHIELD OF MICHIGAN
MI
01
—
1013294628
COMPANY/GROUP NPI #
MI
Enumeration date
02/25/2013
Last updated
02/25/2013
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