Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | F1-0000443 | DE |
NPI | 1881774792 |
---|---|
Provider Name | Dr. Patrick Trent Ryan |
First Address | Wilmington, DE 19803-2941 |
Second Address | Wilmington, DE 19803-2941 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2006 |
Last Update Date | 18/04/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000516521 | AETNA (01) | DE |
2053546000 | AMERIHEALTH (01) | DE |
2255615000 | KEYSTONE (01) | DE |
510381CHI | BLUE CROSS (01) | DE |
6469570001 | PTAN (01) | DE |