1427016591 NPI number — DR. FRANK M. RYAN M.D.

Table of content: JACQUELINE GOODWIN OTR/L (NPI 1053863142)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427016591 NPI number — DR. FRANK M. RYAN M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RYAN
Provider First Name:
FRANK
Provider Middle Name:
M.
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1427016591
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/02/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12805 LOST LAKE CIR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FORT WASHINGTON
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20744-6307
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11701 LIVINGSTON RD
Provider Second Line Business Practice Location Address:
SUITE 103
Provider Business Practice Location Address City Name:
FORT WASHINGTON
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20744-5104
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-292-7270
Provider Business Practice Location Address Fax Number:
301-203-0740
Provider Enumeration Date:
05/01/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  D0019431 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0400752 . This is a "EVERCARE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 0780385 . This is a "AETNA US HEALTHCARE" identifier , issued by the state of ( MH ) . This identifiers is of the category "OTHER".
  • Identifier: 1417045013 . This is a "CIGNA" identifier , issued by the state of ( MH ) . This identifiers is of the category "OTHER".
  • Identifier: 9711 . This is a "KAISER" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 0400048 . This is a "UNTD HLTHC AMERI-CHOICE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 25970007 . This is a "BCBSNCA" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 521973185 . This is a "PHCS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 26667100 , issued by the state of ( DC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 498199 . This is a "NCPPO" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 4053590 . This is a "AETNA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 42021409 . This is a "BCBS OF MARYLAND" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 02133000000 . This is a "PREFERRED HEALTH" identifier , issued by the state of ( MH ) . This identifiers is of the category "OTHER".
  • Identifier: 256066 . This is a "MAMSI/ALLIANCE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 521973185 . This is a "FIDELITY PMG" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 521973185 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 973631000 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".




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