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Individual
MICHAEL G RYAN
Active
Individual
MICHAEL G RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
01023417
IN
207Q00000X
Family Medicine Physician
Primary
200901870
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000067648
ANTHEM BCBS
IN
01
—
080162612
MEDICARE RAILROAD
—
05
—
200307000A
—
IN
01
—
415089P
SIHO
IN
01
—
4255189
AETNA
—
05
—
64022296
—
KY
Enumeration date
07/11/2006
Last updated
04/01/2010
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