Individual
RYAN PATRICK WERNTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
48 CENTENNIAL WAY, GREENVILLE, SC 29605-4662
(864) 455-1600
(864) 522-8005
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
036.142863
IL
208800000X
Urology Physician
Primary
82909
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1780940023
—
IL
05
—
829090
—
SC
Enumeration date
04/11/2012
Last updated
05/12/2021
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