Provider Demographics
NPI:1285844159
Name:IHLE, RAYAN ELIZABETH (MD)
Entity Type:Individual
Prefix:DR
First Name:RAYAN
Middle Name:ELIZABETH
Last Name:IHLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3100 MACCORKLE AVE SE STE 205
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25304-1228
Mailing Address - Country:US
Mailing Address - Phone:304-388-2303
Mailing Address - Fax:304-388-2390
Practice Address - Street 1:3100 MACCORKLE AVE SE STE 205
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25304-1228
Practice Address - Country:US
Practice Address - Phone:304-720-7305
Practice Address - Fax:304-720-7310
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2020-06-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WV24914207RP1001X, 207RC0200X, 207RP1001X
KY42860207RP1001X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810023969Medicaid
KY42860OtherKENTUCKY BOARD OF MEDICAL LICENSURE