Individual
RYAN DAVID BOENTE
Active
Individual
RYAN DAVID BOENTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01078956A
IN
207R00000X
Internal Medicine Physician
57-
OH
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
01078956A
IN
207RP1001X
Pulmonary Disease Physician
01078956A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001186097
ANTHEM PTAN
IN
01
—
000001191723
ANTHEM PTAN
IN
05
—
300001940
—
IN
Enumeration date
07/01/2011
Last updated
03/04/2025
Update your record
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