Provider Demographics
NPI:1003299413
Name:SONDERGARD, RYAN BRADLEY (DO)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:BRADLEY
Last Name:SONDERGARD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4800 N SCOTTSDALE RD STE 2500
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-7630
Mailing Address - Country:US
Mailing Address - Phone:216-468-5000
Mailing Address - Fax:
Practice Address - Street 1:2458 OLD DORSETT RD STE 110
Practice Address - Street 2:
Practice Address - City:MARYLAND HEIGHTS
Practice Address - State:MO
Practice Address - Zip Code:63043-2423
Practice Address - Country:US
Practice Address - Phone:636-939-2550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-02
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO20160446572084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry