Individual
RYAN S SQUIRES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
705 RILEY HOSPITAL DR RM 1803, INDIANAPOLIS, IN 46202-5109
(702) 496-4677
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01085987A
IN
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
01085987A
IN
208000000X
Pediatrics Physician
R-11292
IA
Other
Enumeration date
06/07/2018
Last updated
07/12/2021
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