Individual
LORETTA A RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1434 CHESTER BLVD, RICHMOND, IN 47374-1947
(765) 966-5527
(765) 966-5527
Mailing address
1434 CHESTER BLVD, RICHMOND, IN 47374-1947
(765) 966-5527
(765) 966-5527
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01048837A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000082701
ANTHEM
IN
01
—
200190240
MANAGED HEALTH SERVICES
IN
05
—
200190240
—
IN
05
—
2178567
—
OH
01
—
351265355
TAX ID
IN
Enumeration date
07/04/2006
Last updated
03/07/2023
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