Provider Demographics
NPI:1477871192
Name:VAN WOERKOM, RYAN C (MD)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:C
Last Name:VAN WOERKOM
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1380 E MEDICAL CENTER DR STE 1500
Mailing Address - Street 2:
Mailing Address - City:SAINT GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-2128
Mailing Address - Country:US
Mailing Address - Phone:435-251-2500
Mailing Address - Fax:435-251-2525
Practice Address - Street 1:1380 E MEDICAL CENTER DR STE 1500
Practice Address - Street 2:
Practice Address - City:SAINT GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-2128
Practice Address - Country:US
Practice Address - Phone:801-435-2500
Practice Address - Fax:435-251-2525
Is Sole Proprietor?:No
Enumeration Date:2010-05-05
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXR8283207RC0000X
ORMD183201207RC0000X
390200000X
UT11619461-1205207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program