Individual
MARSHA G RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1237 E MAIN ST, STE C1, CARBONDALE, IL 62901-3148
(618) 457-2281
(618) 529-0573
Mailing address
PO BOX 1105, INDIANAPOLIS, IN 46206-1105
(618) 549-5361
(618) 529-0568
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036061951
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036061951
—
IL
Enumeration date
10/05/2005
Last updated
12/30/2014
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