Individual
DR. RYAN CHRISTOPHER MELVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2550 ADDISON AVE E, SUITE B, TWIN FALLS, ID 83301-6749
(208) 814-7700
(208) 933-9301
Mailing address
PO BOX 587, TWIN FALLS, ID 83303-0587
(208) 814-7400
(208) 814-7491
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
O0418
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807192300
—
ID
01
—
P00659679
MCRR
ID
Enumeration date
06/21/2006
Last updated
01/02/2015
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