Individual
KEVIN MICHAEL RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
35 PEARL ST STE 200, BROCKTON, MA 02301-2866
(508) 588-8034
(508) 897-0475
Mailing address
35 PEARL ST STE 100, BROCKTON, MA 02301-1195
(781) 769-3222
(781) 255-9807
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA7481
MA
363AS0400X
Surgical Physician Assistant
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—
Other
Enumeration date
02/06/2018
Last updated
04/18/2023
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