Individual
RYAN JAMES WALCZAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
146 E HOSPITAL DR, STE 200, WEST COLUMBIA, SC 29169-2306
(803) 936-7530
(803) 936-7532
Mailing address
PO BOX 6069, WEST COLUMBIA, SC 29171-6069
(803) 936-7530
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
90440
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/06/2018
Last updated
01/16/2024
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