Provider Demographics
NPI:1790740033
Name:RYAN, PATRICIA M (MD)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:M
Last Name:RYAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7255 HANOVER GREEN DR
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23111-1706
Mailing Address - Country:US
Mailing Address - Phone:804-730-1111
Mailing Address - Fax:804-730-9764
Practice Address - Street 1:7255 HANOVER GREEN DR
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23111-1706
Practice Address - Country:US
Practice Address - Phone:804-730-1111
Practice Address - Fax:804-730-9764
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2013-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101058016207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAH17990Medicare UPIN
VA002762P95Medicare PIN