Provider Demographics
NPI:1992776017
Name:ROYER, GENE
Entity type:Individual
Prefix:
First Name:GENE
Middle Name:
Last Name:ROYER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:253 BRIDGTON RD
Mailing Address - Street 2:
Mailing Address - City:FRYEBURG
Mailing Address - State:ME
Mailing Address - Zip Code:04037-1438
Mailing Address - Country:US
Mailing Address - Phone:207-935-3383
Mailing Address - Fax:207-935-3632
Practice Address - Street 1:70 MAIN ST
Practice Address - Street 2:
Practice Address - City:PORTER
Practice Address - State:ME
Practice Address - Zip Code:04068-3527
Practice Address - Country:US
Practice Address - Phone:207-625-8126
Practice Address - Fax:207-625-7820
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME1155207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME000209016Medicaid
ME000209016Medicaid
MEMM3796Medicare ID - Type Unspecified
MEMM379601Medicare PIN