Individual
DR. PHILIP J A RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
176 HEALTH CARE LN, SUITE B, MARTINSBURG, WV 25401-4010
(304) 260-1060
(304) 260-1062
Mailing address
176 HEALTH CARE LN, SUITE B, MARTINSBURG, WV 25401-4010
(304) 260-1060
(304) 260-1062
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
01126
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001714408
BLUE CROSS BLUE SHIELD
WV
05
—
2006615000
—
WV
Enumeration date
10/31/2006
Last updated
02/07/2012
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