Individual
RYAN DAVID MALLORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2525 W UNIVERSITY AVE STE 300, MUNCIE, IN 47303-3432
(765) 289-5420
(765) 281-2040
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
01076590A
IN
207RI0011X
Interventional Cardiology Physician
036166970
IL
207RI0011X
Interventional Cardiology Physician
Primary
C1703
KY
390200000X
Student in an Organized Health Care Education/Training Program
11017770A
IN
Other
Enumeration date
06/12/2014
Last updated
03/04/2026
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