Provider Demographics
NPI:1962653725
Name:RYAN, CHRISTINE MARY (DO)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:MARY
Last Name:RYAN
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:1310 WISCONSIN AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:GRAND HAVEN
Mailing Address - State:MI
Mailing Address - Zip Code:49417-2472
Mailing Address - Country:US
Mailing Address - Phone:616-844-4528
Mailing Address - Fax:616-847-5608
Practice Address - Street 1:1310 WISCONSIN AVE
Practice Address - Street 2:SUITE 301
Practice Address - City:GRAND HAVEN
Practice Address - State:MI
Practice Address - Zip Code:49417-2472
Practice Address - Country:US
Practice Address - Phone:616-847-1860
Practice Address - Fax:616-844-4670
Is Sole Proprietor?:No
Enumeration Date:2008-10-09
Last Update Date:2014-09-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI5101018025207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine