Organization
GORDON A.RYAN,MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MILDRED R COLE RMA (OFFICE MGR.)
(757) 624-9433
Entity
Organization
Contact information
Practice address
400 GRESHAM DR, SUITE 411, NORFOLK, VA 23507-1901
(757) 624-9433
(757) 624-6884
Mailing address
400 GRESHAM DR, SUITE 411, NORFOLK, VA 23507-1901
(757) 624-9433
(757) 624-6884
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0101034688
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005878900
—
VA
Enumeration date
01/08/2008
Last updated
01/08/2008
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