Provider Demographics
NPI:1275983058
Name:DULINA, RYAN
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:DULINA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1410 IVY MEADOW DR
Mailing Address - Street 2:SUITE 1511
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28213-9021
Mailing Address - Country:US
Mailing Address - Phone:570-401-6120
Mailing Address - Fax:
Practice Address - Street 1:1410 IVY MEADOW DR
Practice Address - Street 2:SUITE 1511
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28213-9021
Practice Address - Country:US
Practice Address - Phone:570-401-6120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-13
Last Update Date:2016-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)