Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | OS003346L | PA |
N | 2080P0208X | Pediatric Infectious Diseases | OS003346L | PA |
NPI | 1669438644 |
---|---|
Provider Name | Dr. Michael E. Ryan |
First Address | Danville, PA 17822-9800 |
Second Address | Danville, PA 17822-9800 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C28826 | (02) |