Provider Demographics
NPI:1639435951
Name:ATEM, RYAN
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:ATEM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9867 GOOD LUCK RD
Mailing Address - Street 2:APT#12
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-3208
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9867 GOOD LUCK RD
Practice Address - Street 2:APT#12
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-3208
Practice Address - Country:US
Practice Address - Phone:202-722-1725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-11
Last Update Date:2012-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide