Provider Demographics
NPI:1073882668
Name:RYAN, MICHAEL NIXON (M D)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:NIXON
Last Name:RYAN
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:106 HIDDEN PT
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-5546
Mailing Address - Country:US
Mailing Address - Phone:615-824-8496
Mailing Address - Fax:615-826-1833
Practice Address - Street 1:106 HIDDEN PT
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-5546
Practice Address - Country:US
Practice Address - Phone:615-824-8496
Practice Address - Fax:615-826-1833
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-28
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN7107207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNB04821Medicare UPIN