Provider Demographics
NPI:1598962953
Name:VANMAANEN, RYAN JEFFREY (DO)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:JEFFREY
Last Name:VANMAANEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 HICKMAN RD
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50314-1548
Mailing Address - Country:US
Mailing Address - Phone:515-282-5773
Mailing Address - Fax:515-282-2332
Practice Address - Street 1:1801 HICKMAN RD
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50314-1548
Practice Address - Country:US
Practice Address - Phone:515-282-5773
Practice Address - Fax:515-282-2332
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-29
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA3909207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine