Individual
JENNIFER L RYAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
825 FAIRFAX AVE, SUITE 445, NORFOLK, VA 23507-1914
(757) 446-5955
(757) 446-5196
Mailing address
PO BOX 936, NORFOLK, VA 23501-0936
(757) 446-5955
(757) 446-5196
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101241625
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
-002 -003 -028
TRICARE/CHAMPUS
VA
01
—
07269
NC BCBS
NC
01
—
10022014
SENTARA/OPTIMA
VA
05
—
1801017124
—
VA
01
—
2167093
UHC/MAMSI
VA
01
—
303762
ANTHEM BC/BS (INERNAL MEDICINE)
VA
01
—
303765
ANTHEM BC/BS (GHENT FAMILY MEDICINE)
VA
01
—
PAR
MULTIPLAN
VA
Enumeration date
05/02/2007
Last updated
01/23/2009
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