Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208D00000X | General Practice Physician | 28482 | WV |
NPI | 1013302140 |
---|---|
Provider Name | Ryan Budwany |
First Address | Charleston, WV 25301-1652 |
Second Address | Charleston, WV 25301-1652 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2015 |
Last Update Date | 30/11/2021 |