Individual
MR. RYAN JEFFREY CALDWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
18101 OAKWOOD BLVD, DEARBORN, MI 48124-4089
(313) 593-7000
Mailing address
26901 BEAUMONT BLVD STE 3D, SOUTHFIELD, MI 48033-3849
(947) 522-1848
(947) 522-0307
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704302102
MI
363L00000X
Nurse Practitioner
Primary
4704302102
MI
363LA2100X
Acute Care Nurse Practitioner
4704302102
MI
Other
Enumeration date
05/21/2021
Last updated
08/31/2022
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