Gallivan, Ryan P

Gallivan, Ryan P is an individual health care provider with primary practice located at 2450 Ne Mary Rose Pl Suite 120, Bend OR 97701-7132. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as his primary health care specialty. Gallivan, Ryan P can be contacted via phone (541) 382-3100.

Contact Information

Primary practice address
2450 Ne Mary Rose Pl Suite 120 Bend OR 97701-7132
Fax: (541) 312-7050
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X 23746 Oregon

Profile Details

NPI number 1043292196
LBN Legal business name Gallivan, Ryan P
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 15th, 2005
Last updated Mar 10th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043292196 NPPES
Oregon MEDICAID 286590

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