Individual
RYAN THREADGILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3000 NEW BERN AVE, RALEIGH, NC 27610-1231
(919) 350-7270
(919) 350-7204
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
202100644
NC
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
2021-0644
NC
207RP1001X
Pulmonary Disease Physician
2021-0644
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/18/2017
Last updated
10/24/2022
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