Individual
RYAN J MCCLAINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 GREG KRUSCHEK AVE, NOME, AK 99762
(907) 443-3311
Mailing address
1000 GREG KRUSCHEK AVE, NOME, AK 99762
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
122943
AK
207Q00000X
Family Medicine Physician
Primary
160563
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
160563
STATE LICENSURE
AK
05
—
1670719
—
AK
Enumeration date
04/18/2017
Last updated
02/02/2023
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