Individual provider · Type 1 NPI

Royce Blackwood, PA-C

Surgical Physician Assistant · Bangor, ME

NPI number 1992286546 Active

Practice location

360 Broadway
Bangor, ME 04401-3979

Fax (207) 907-3660

Mailing address

C/o St Marys Health System - Provider Enrollment, PO Box 7291
Lewiston, ME 04243-7291

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant 363AS0400XNone listed
Surgical Physician Assistant Primary 363AS0400XPA1855 (ME)

Surgical Physician Assistant: Definition to come...

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About NPI 1992286546

Royce Blackwood, PA-C's National Provider Identifier is 1992286546, issued on Aug 22, 2018. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Bangor, ME. The record was last updated on Feb 3, 2022.