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Individual
RYAN ANTONAWICH
Active
Individual
RYAN ANTONAWICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
5101027619
MI
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
10177
NE
390200000X
Student in an Organized Health Care Education/Training Program
5151015844
MI
Other
Enumeration date
06/08/2022
Last updated
04/23/2025
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