Individual
DR. RYAN JAMES MACDONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7173 E SUPER 1 LOOP, STE A, ATHOL, ID 83801
(208) 561-9970
(208) 561-9997
Mailing address
1593 E POLSTON AVE, POST FALLS, ID 83854-5326
(208) 262-2498
(208) 262-7461
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
M-16953
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1255565933
—
ID
Enumeration date
05/08/2009
Last updated
04/16/2025
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