Provider Demographics
NPI:1962841593
Name:BARMORE, RYAN PETER (MD)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:PETER
Last Name:BARMORE
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 1:2410 W 16TH ST
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-6004
Mailing Address - Country:US
Mailing Address - Phone:970-810-5612
Mailing Address - Fax:
Practice Address - Street 1:2410 W 16TH ST
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-6004
Practice Address - Country:US
Practice Address - Phone:970-810-5612
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-17
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLL357482084N0400X
FLME1312982084N0400X
CODR.00620292084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL100813500Medicaid