Provider Demographics
NPI:1265183354
Name:RYSE HEALTH MARYLAND PHYSICIANS, PC
Entity type:Organization
Organization Name:RYSE HEALTH MARYLAND PHYSICIANS, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF MEDICAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:P
Authorized Official - Last Name:TYNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:571-999-7973
Mailing Address - Street 1:3700 KOPPERS ST STE 510
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21227-1051
Mailing Address - Country:US
Mailing Address - Phone:240-900-8808
Mailing Address - Fax:
Practice Address - Street 1:3700 KOPPERS ST STE 510
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21227-1051
Practice Address - Country:US
Practice Address - Phone:240-900-8808
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RYSE HEALTH, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-01-11
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty