Individual
RYAN ERIC EMBERTSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
300 SINGLETON RIDGE RD, CONWAY, SC 29526-9142
(800) 841-4236
(843) 497-8566
Mailing address
7809 MONARCH DR, MYRTLE BEACH, SC 29572-4293
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
2017-01019
NC
2085R0202X
Diagnostic Radiology Physician
Primary
82112
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
821123
—
SC
Enumeration date
03/22/2013
Last updated
07/09/2019
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