Individual
JOHN B RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11012 E 13 MILE RD STE 201, WARREN, MI 48093-2547
(586) 582-0864
(586) 582-0964
Mailing address
11012 E 13 MILE RD STE 201, WARREN, MI 48093-2547
(586) 582-0864
(586) 582-0964
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
4301068798
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4528910
—
MI
01
—
JR068798
BCBS PIN #
MI
Enumeration date
08/18/2005
Last updated
08/25/2023
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