Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | 01064970A | IN |
N | 207VE0102X | Reproductive Endocrinologist | 2020-02253 | NC |
NPI | 1518189885 |
---|---|
Provider Name | Dr. Greene Donald Royster IV |
First Address | San Antonio, TX 78251 |
Second Address | Kinston, NC 28501-4932 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2007 |
Last Update Date | 02/06/2020 |