Provider Demographics
NPI:1780861476
Name:RYAN, BRENT JONATHAN (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:BRENT
Middle Name:JONATHAN
Last Name:RYAN
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Gender:M
Credentials:MD, MPH
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Mailing Address - Street 1:800 E 28TH ST
Mailing Address - Street 2:MAIL ROUTE 11326
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-3799
Mailing Address - Country:US
Mailing Address - Phone:612-863-7560
Mailing Address - Fax:612-863-3809
Practice Address - Street 1:2925 CHICAGO AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55407-1321
Practice Address - Country:US
Practice Address - Phone:613-863-4000
Practice Address - Fax:763-236-3026
Is Sole Proprietor?:No
Enumeration Date:2008-01-25
Last Update Date:2022-05-25
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Provider Licenses
StateLicense IDTaxonomies
MN48748207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine