Individual
DR. JACQUELINE RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
11116 MEDICAL CAMPUS RD, HAGERSTOWN, MD 21742-6710
(301) 790-8804
Mailing address
PO BOX 64916, BALTIMORE, MD 21264-4916
(443) 481-6573
(444) 481-6515
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D0057078
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0017
CAREFIRST BCBS
DC
01
—
110243912
RR MEDICARE
MD
01
—
3112374
AETNA HMO
MD
01
—
61003502
CAREFIRST BCBS
MD
01
—
7539450
AETNA PPO
MD
05
—
827402900
—
MD
Enumeration date
03/17/2006
Last updated
02/28/2023
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