# MICHAEL G RYAN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1386679496
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 01023417 | IN | — |
| 207Q00000X | Family Medicine Physician | 200901870 | NC | Yes |

## Other

- **Enumeration date:** 07/11/2006
- **Last updated:** 04/01/2010

## 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 |