Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 4301406659 | MI |
Y | 111NI0900X | Internist | 4301406659 | MI |
N | 207RA0401X | Internist - Addiction Medicine | 4301406659 | MI |
NPI | 1164574927 |
---|---|
Provider Name | Dr. Robin Ann Royster |
First Address | Grant, MI 49327-0007 |
Second Address | Grant, MI 49327-7900 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2007 |
Last Update Date | 29/06/2011 |