Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 42430 | KY |
NPI | 1013126564 |
---|---|
Provider Name | Dr. Ryann Acquino Pangan |
First Address | Ashland, KY 41105-2379 |
Second Address | Ashland, KY 41101-2876 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2007 |
Last Update Date | 06/04/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2949582 | (05) | OH |
3810015249 | (05) | WV |
7100083160 | (05) | KY |