Provider Demographics
NPI:1902830268
Name:RYNNE, MICHAEL VAUGHAN (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:VAUGHAN
Last Name:RYNNE
Suffix:
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 1:1126 LAMPWICK LANE
Mailing Address - Street 2:
Mailing Address - City:MURRELLS INLET
Mailing Address - State:SC
Mailing Address - Zip Code:29576
Mailing Address - Country:US
Mailing Address - Phone:910-322-5894
Mailing Address - Fax:910-822-7970
Practice Address - Street 1:1126 LAMPWICK LN
Practice Address - Street 2:
Practice Address - City:MURRELLS INLET
Practice Address - State:SC
Practice Address - Zip Code:29576-7226
Practice Address - Country:US
Practice Address - Phone:910-322-5894
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC36238207W00000X
ME6967207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology