Provider Demographics
NPI:1013302140
Name:BUDWANY, RYAN (MD)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:BUDWANY
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 1:400 COURT ST STE 100
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25301-1652
Mailing Address - Country:US
Mailing Address - Phone:304-347-6120
Mailing Address - Fax:304-347-6126
Practice Address - Street 1:400 COURT ST STE 100
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25301-1652
Practice Address - Country:US
Practice Address - Phone:304-347-6120
Practice Address - Fax:304-347-6126
Is Sole Proprietor?:No
Enumeration Date:2015-04-06
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV284822083X0100X, 208D00000X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine