Individual
DR. RYAN DANE REBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
100 E LANCASTER AVE, SUITE 230, WYNNEWOOD, PA 19096-3450
(610) 642-3796
(610) 642-3796
Mailing address
100 E LANCASTER AVE, SUITE 230, WYNNEWOOD, PA 19096-3450
(610) 642-3796
(610) 642-3796
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
OS016831
PA
207RP1001X
Pulmonary Disease Physician
Primary
OS016831
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0010768900007
—
PA
01
—
232359401
MAIN LINE HEALTHCARE TAX ID
PA
Enumeration date
08/25/2009
Last updated
09/14/2015
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