Provider Demographics
NPI:1578602249
Name:RYAN, WILLIAM JAMES II (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:JAMES
Last Name:RYAN
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1236 HUFFMAN MILL RD
Mailing Address - Street 2:MEDICAL ARTS CNTR #2300
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215
Mailing Address - Country:US
Mailing Address - Phone:336-538-0901
Mailing Address - Fax:336-538-0145
Practice Address - Street 1:1236 HUFFMAN MILL RD
Practice Address - Street 2:MEDICAL ARTS CNTR #2300
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215
Practice Address - Country:US
Practice Address - Phone:336-538-0901
Practice Address - Fax:336-538-0145
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC183802084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8974098Medicaid
C80788Medicare UPIN
NC201617Medicare ID - Type Unspecified