Provider Demographics
NPI:1467475053
Name:RYAN, BRADLEY C (MD)
Entity Type:Individual
Prefix:
First Name:BRADLEY
Middle Name:C
Last Name:RYAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:10401 SPOTSYLVANIA AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22408-8606
Mailing Address - Country:US
Mailing Address - Phone:540-318-1515
Mailing Address - Fax:540-371-4849
Practice Address - Street 1:10401 SPOTSYLVANIA AVE STE 204
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22408-8606
Practice Address - Country:US
Practice Address - Phone:540-318-1515
Practice Address - Fax:540-371-4849
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2023-03-09
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Provider Licenses
StateLicense IDTaxonomies
VA0101240317208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery