Provider Demographics
NPI:1932136926
Name:JANDER, RYAN MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:MICHAEL
Last Name:JANDER
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 1:8926 WOODYARD ROAD
Mailing Address - Street 2:SUITE 701
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735
Mailing Address - Country:US
Mailing Address - Phone:301-856-1682
Mailing Address - Fax:301-856-0964
Practice Address - Street 1:8926 WOODYARD ROAD
Practice Address - Street 2:SUITE 701
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735
Practice Address - Country:US
Practice Address - Phone:301-856-1682
Practice Address - Fax:301-856-0964
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2013-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0064678207X00000X, 207XS0106X
VA0101239951207X00000X, 207XS0106X
DCMD036127207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
238582OtherANTHEM PROVIDER #
DC46950028OtherBCBS NCA PROVIDER#
52 1054342OtherGMO GROUP TAX ID #
DC176608OtherMETRO MEDICARE GMO GRP#
MDP00457403OtherRAIL ROAD MEICARE
5722200OtherFIRST HEALTH PROVIDER#
0458905OtherCIGNA PROVIDER #
763904OtherNCPPO PROVIDER#
238578OtherANTHEM PROVIDER #
MD462LQ643OtherMARYLAND MEDICARE
1359236OtherAETNA HMO
238575OtherANTHEM PROVIDER #
7799886OtherAETNA PPO PROVIDER#
VAP00457403OtherRAIL ROAD MEDICARE
MD892834OtherBCBS MD INDIV PROV#
DC019805G08Medicare ID - Type UnspecifiedMETRO MEDICARE PROVIDER#
1359236OtherAETNA HMO
I60636Medicare UPIN
0254450002Medicare NSC