Individual
RYAN KEVIN RIDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
800 N FANT ST, ANDERSON, SC 29621-5708
(864) 512-1335
(864) 512-8575
Mailing address
1 INDEPENDENCE PT, SUITE 212, GREENVILLE, SC 29615-4545
(864) 797-6306
(864) 797-6198
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
19706
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5901116
—
NC
05
—
595784016A
—
GA
01
—
P00177247
RAILROAD MEDICARE
SC
05
—
T37332
—
SC
Enumeration date
04/21/2006
Last updated
12/10/2020
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