Ryan, Michael J

Ryan, Michael J is an individual health care provider with primary practice located at 232 S Whisperwood Way , Boise ID 83709-4900. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / General Practice is his primary health care specialty. Ryan, Michael J can be contacted via phone (208) 350-6450.

Contact Information

Primary practice address
232 S Whisperwood Way Boise ID 83709-4900
Phone: (208) 350-6450
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X M5502 Idaho
Allopathic & Osteopathic Physicians / General Practice 208D00000X M5502 Idaho

Profile Details

NPI number 1821039025
LBN Legal business name Ryan, Michael J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 9th, 2006
Last updated Mar 12th, 2014 - about 11 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 1821039025 NPPES
Idaho MEDICAID 003908900

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