Provider Demographics
NPI:1275853384
Name:SHANKS, RYAN HENRY (MD)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:HENRY
Last Name:SHANKS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:170 MANNING DR
Mailing Address - Street 2:DEPARTMENT OF EMERGENCY MEDICINE, CB# 7594
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-4221
Mailing Address - Country:US
Mailing Address - Phone:919-966-6440
Mailing Address - Fax:919-966-3049
Practice Address - Street 1:170 MANNING DR
Practice Address - Street 2:DEPARTMENT OF EMERGENCY MEDICINE, CB# 7594
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-4221
Practice Address - Country:US
Practice Address - Phone:919-966-6440
Practice Address - Fax:919-966-3049
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-11
Last Update Date:2020-02-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TN49979207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine