Individual
DR. MARK THOMAS RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
25625 SCHOENHERR RD, WARREN, MI 48089-1451
(586) 759-4700
(586) 759-1504
Mailing address
25625 SCHOENHERR RD, WARREN, MI 48089-1499
(586) 759-4700
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
5101016208
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200E009780
BCBSM/BCN
MI
Enumeration date
03/27/2007
Last updated
09/29/2014
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