Individual
DR. MICHAEL HUNTER RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1620 SOUTHRIDGE DR STE B, JEFFERSON CITY, MO 65109-4005
(573) 632-2780
(573) 632-2782
Mailing address
1620 SOUTHRIDGE DR STE B, JEFFERSON CITY, MO 65109-4005
(573) 632-2780
(573) 632-2782
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
118143
MO
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
118143
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
203959903
—
MO
Enumeration date
06/14/2005
Last updated
09/12/2018
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