Provider Demographics
NPI:1295898187
Name:GAINES, RYAN ANDREW (MD)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:ANDREW
Last Name:GAINES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2535 S DOWNING ST
Mailing Address - Street 2:SUITE #480
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-5847
Mailing Address - Country:US
Mailing Address - Phone:303-778-5658
Mailing Address - Fax:
Practice Address - Street 1:2555 S DOWNING ST
Practice Address - Street 2:SUITE #100
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-5855
Practice Address - Country:US
Practice Address - Phone:303-778-5658
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO50313207YX0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck