Individual
DR. RYAN MICHAEL NORMAN
Active
Individual
DR. RYAN MICHAEL NORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2008025169
MO
207RN0300X
Nephrology Physician
4250
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1659574218
—
MO
05
—
189833003
—
AR
01
—
2008025169
STATE LICENSE
MO
01
—
4250
MEDICAL LICENSE
OK
01
—
431560263
TRICARE
MO
Enumeration date
06/08/2007
Last updated
12/10/2020
Update your record
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