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Individual

DR. RYAN E DODDE II

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3124 N WELLNESS DR, SUITE 10, HOLLAND, MI 49424-8121
(616) 738-5870
(616) 738-5872
Mailing address
3124 N WELLNESS DR, SUITE 10, HOLLAND, MI 49424-8121
(616) 738-5870
(616) 738-5872

Taxonomy

Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
4301063317
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
07010911
BLUE CROSS PIN NUMBER
MI
01
128516
PREFERRED CHOICES ID NO.
MI
01
13-30028
IBA INSURANCE ID NUMBER
MI
01
2221956
CIGNA PPO ID NUMBER
MI
01
24-07010911
BCBS ID NUMBER
MI
01
7254148
AETNA ID NUMBER
MI
Enumeration date
02/20/2006
Last updated
10/17/2007
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