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Individual

MR. RYAN WILLIAM FLANAGAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1730 MOUNT VERNON RD STE B, ATLANTA, GA 30338-4245
(770) 353-2001
Mailing address
225 26TH ST NW APT 8408, ATLANTA, GA 30309-1901
(631) 807-5979

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
10554
GA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
G29381B
GA
Enumeration date
04/24/2020
Last updated
09/28/2022
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