Individual
RYAN JAMES MCLENNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2011
Mailing address
105 BRAEBURN DR, WINSTON SALEM, NC 27127-4690
(540) 588-4067
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2014-01654
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/11/2012
Last updated
03/03/2015
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