Provider Demographics
NPI:1700994019
Name:YODER, RYAN LAWRENCE (MD)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:LAWRENCE
Last Name:YODER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:70 MICHIGAN AVE W
Mailing Address - Street 2:SUITE 250
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49017-3614
Mailing Address - Country:US
Mailing Address - Phone:269-969-6177
Mailing Address - Fax:269-969-8776
Practice Address - Street 1:70 MICHIGAN AVE W
Practice Address - Street 2:SUITE 250
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49017-3614
Practice Address - Country:US
Practice Address - Phone:269-969-6177
Practice Address - Fax:269-969-8776
Is Sole Proprietor?:No
Enumeration Date:2006-08-27
Last Update Date:2023-11-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI43010795652084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4301079565OtherSTATE LICENSE NUMBER
MIP00352218OtherRAILROAD MEDICARE
MI0A31027OtherBLUE CROSS BLUE SHIELD GROUP PIN
MI130131662OtherBLUE CROSS BLUE SHIELD PIN
MI4915744Medicaid
MICN7211OtherRAILROAD MEDICARE GROUP PIN
MII61526Medicare UPIN
MI130131662OtherBLUE CROSS BLUE SHIELD PIN