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Individual

RYAN KORODAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
16981 KENSINGTON DR, MACOMB, MI 48044-4093
(586) 604-1952
Mailing address
16981 KENSINGTON DR, MACOMB, MI 48044-4093
(586) 604-1952

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704285840
MI
367500000X
Certified Registered Nurse Anesthetist
Primary
4704285840
MI

Other

Enumeration date
07/11/2021
Last updated
11/15/2023
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