Individual
BRANDON RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C, NREMT-P
Contact information
Practice address
1705 GARDNER RD, WILMINGTON, NC 28405-8873
(910) 343-5300
Mailing address
1705 GARDNER RD, WILMINGTON, NC 28405-8873
(910) 343-5300
Taxonomy
Speciality
Code
Description
License number
State
146L00000X
Paramedic
6611
GA
146L00000X
Paramedic
P071746
NC
363A00000X
Physician Assistant
Primary
0010-01834
NC
363AM0700X
Medical Physician Assistant
0010-01834
NC
363AM0700X
Medical Physician Assistant
PA06145
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0850PA
—
SC
01
—
1285825208
CHAMPUS
NC
01
—
P00780675
RAILROAD MEDICARE
NC
Enumeration date
08/06/2007
Last updated
08/25/2025
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