Basic Information
| Provider Information | |||||||||
| NPI: | 1821164013 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JOSEPH | ||||||||
| FirstName: | ROY | ||||||||
| MiddleName: | GEORGE | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7500 GREENWAY CENTER DR | ||||||||
| Address2: | PPQA MEDICARE COMPLIANCE UNIT 6 WEST ATTN THERESA BROOK | ||||||||
| City: | GREENBELT | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207703502 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3014772907 | ||||||||
| FaxNumber: | 3014772981 | ||||||||
| Practice Location | |||||||||
| Address1: | 10810 CONNECTICUT AVENUE | ||||||||
| Address2: | |||||||||
| City: | KENSINGTON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208952138 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3019297550 | ||||||||
| FaxNumber: | 3019297540 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/28/2006 | ||||||||
| LastUpdateDate: | 11/01/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208800000X | 0101055972 | VA | N | Allopathic & Osteopathic Physicians | Urology | 208800000X | MD30279 | DC | N | Allopathic & Osteopathic Physicians | Urology | 208800000X | D52172 | MD | Y | Allopathic & Osteopathic Physicians | Urology |
No ID Information.