Individual
DR. RYAN CHANNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2500 ENGLISH CREEK AVE STE 1300, EGG HARBOR TOWNSHIP, NJ 08234-5598
(800) 321-9999
(267) 479-1321
Mailing address
833 CHESTNUT ST STE 520, PHILADELPHIA, PA 19107-4430
(267) 606-4478
(267) 339-3761
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
25MA10209400
NJ
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
25MA10209400
NJ
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
MT201720
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
PA
Other
Enumeration date
05/09/2012
Last updated
11/26/2021
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