Individual
RYAN PATRICK MACDONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
820 ARBUTUS AVE, OCONTO, WI 54153-2004
(920) 835-1100
(920) 835-1099
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7222
(920) 445-7289
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2957-023
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1105838
NCCPA ID
WI
Enumeration date
07/16/2012
Last updated
03/14/2022
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