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Individual

RYAN MCDONALD WALLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
8401 CONNECTICUT AVE STE 201, CHEVY CHASE, MD 20815-5829
(301) 907-3960
(301) 652-4933
Mailing address
8401 CONNECTICUT AVE STE 201, CHEVY CHASE, MD 20815-5829
(301) 907-3960
(703) 391-2919

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
0101273165
VA
208000000X
Pediatrics Physician
23943
AL
208000000X
Pediatrics Physician
Primary
D95493
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
51501226
BLUE CROSS PROVIDER ID
AL
01
631061517
FEDERAL TAX ID
01
7423246
AETNA PROVIDER ID
Enumeration date
08/14/2006
Last updated
12/01/2022
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