# DIABETES, ENDOCRINOLOGY & LIPIDOLOGY CENTER, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275810830
- **Authorized official:** DR. PHILIP JOSEPH RYAN M.D. (PRESIDENT)
- **Authorized official phone:** (304) 260-1060

## Contact information

- **Practice address:** 176 HEALTH CARE LN, SUITE B, MARTINSBURG, WV 25401-4010
- **Practice address phone:** (304) 260-1060
- **Practice address fax:** (304) 260-1062
- **Mailing address:** 176 HEALTH CARE LN, SUITE B, MARTINSBURG, WV 25401-4010
- **Mailing address phone:** (304) 260-1060
- **Mailing address fax:** (304) 260-1062

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | 21393 | WV | Yes |

## Other

- **Enumeration date:** 11/10/2011
- **Last updated:** 02/07/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 3810022262 | — | WV |