1457351918 NPI number — DR. ROY MOREIRA MD

Table of content: DR. ROY MOREIRA MD (NPI 1457351918)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457351918 NPI number — DR. ROY MOREIRA MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MOREIRA
Provider First Name:
ROY
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1457351918
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/20/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
411 PARKWAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GREENSBORO
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27401-1644
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
336-574-0464
Provider Business Mailing Address Fax Number:
336-574-0467

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
411 PARKWAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREENSBORO
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27401-1644
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-574-0464
Provider Business Practice Location Address Fax Number:
336-574-0467
Provider Enumeration Date:
07/27/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  9400106 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 460480116 . This is a "ONE HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 8960651 . This is a "CAROLINA ACCESS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 460480116 . This is a "FOCUS BEECH STREET" identifier . This identifiers is of the category "OTHER".
  • Identifier: 834787 . This is a "OPTIMUM C" identifier . This identifiers is of the category "OTHER".
  • Identifier: 460480116 . This is a "GUARDIAN MEDCOST" identifier . This identifiers is of the category "OTHER".
  • Identifier: 460480116 . This is a "HEALTHCARE SAVINGS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 460480116 . This is a "PHCS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 460480116 . This is a "PRIMARY CARE PHYSICIAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 834787 . This is a "MAMSI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 460480116 . This is a "GREAT WEST ONE HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5981 . This is a "PARTNERS MCA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 460480116 . This is a "FIRST HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4552971 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5981 . This is a "PARTNERS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 110242882 . This is a "RRM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 460480116 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 60651 . This is a "BCBS" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 8960651 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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