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Individual

MR. KEITH A RYAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2305 37TH AVE SW, MINOT, ND 58701-7669
(701) 857-5000
Mailing address
PO BOX 5010, MINOT, ND 58702-5010
(701) 857-5000

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
10216
SD
207L00000X
Anesthesiology Physician
Primary
19760
ND
207L00000X
Anesthesiology Physician
7118A
WY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
120997300
WY
01
P00229238
RAILROAD MEDICARE
WY
Enumeration date
12/12/2006
Last updated
06/08/2023
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