Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | D0083075 | MD |
NPI | 1013232693 |
---|---|
Provider Name | Dr. Ryan Christopher Cleary |
First Address | Owings Mills, MD 21117-5437 |
Second Address | Baltimore, MD 21237-4360 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2010 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
276605100 | (05) | MD |