1710043641 NPI number — DANIEL J RYAN MD PC

Table of content: (NPI 1710043641)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710043641 NPI number — DANIEL J RYAN MD PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DANIEL J RYAN MD PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1710043641
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/20/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1113 VILLA LINDE CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FLINT
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48532-3410
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
810-733-1214
Provider Business Mailing Address Fax Number:
810-733-3011

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1113 VILLA LINDE CT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FLINT
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48532-3410
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
810-733-1214
Provider Business Practice Location Address Fax Number:
810-733-3011
Provider Enumeration Date:
12/28/2006

Additional Information

Authorized Official

Authorized Official Last Name:
RYAN
Authorized Official First Name:
DANIEL
Authorized Official Middle Name:
J
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
810-733-1214

Provider Taxonomy Codes

  • Taxonomy code: 207W00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 07308 . This is a "M CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0988882 . This is a "GENESEE HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7650396 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1004688 . This is a "MCLAREN HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 180044733 . This is a "RR MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4218962 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: DR068574 . This is a "BLUE CHOICE THRU BCN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0988882 . This is a "HEALTH PLUS" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 1004688 . This is a "MCLAREN HEALTH ADVANTAGE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1802505282 . This is a "BCBS" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 1802505282 . This is a "BLUE CROSS NETWORK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1867250 . This is a "FIRST HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: C7308 . This is a "KIDS CARE OF MI" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com