Provider Demographics
NPI:1174840045
Name:MYERS, RYAN (MD)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:MYERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10789 BRADFORD RD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-6403
Mailing Address - Country:US
Mailing Address - Phone:303-738-2714
Mailing Address - Fax:303-738-2741
Practice Address - Street 1:10789 BRADFORD RD
Practice Address - Street 2:SUITE 150
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80127-6403
Practice Address - Country:US
Practice Address - Phone:303-738-2714
Practice Address - Fax:303-738-2741
Is Sole Proprietor?:No
Enumeration Date:2010-04-30
Last Update Date:2013-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO52959207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine