Provider Demographics
NPI:1720358229
Name:ROYAL, MARCEL MARC (EMT - INTERMEDIATE)
Entity type:Individual
Prefix:MR
First Name:MARCEL
Middle Name:MARC
Last Name:ROYAL
Suffix:
Gender:M
Credentials:EMT - INTERMEDIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 50771
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29485-0771
Mailing Address - Country:US
Mailing Address - Phone:843-408-6408
Mailing Address - Fax:
Practice Address - Street 1:8465 PATRIOT BLVD
Practice Address - Street 2:APT. 1
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29420-7407
Practice Address - Country:US
Practice Address - Phone:843-408-6408
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-31
Last Update Date:2011-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)