Provider Demographics
NPI:1740484161
Name:RYAN, MIRIAM W (MD)
Entity type:Individual
Prefix:DR
First Name:MIRIAM
Middle Name:W
Last Name:RYAN
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Gender:F
Credentials:MD
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Mailing Address - Street 1:3901 RAINBOW BOULEVARD
Mailing Address - Street 2:6067 DELP, MAIL STOP 1028
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160
Mailing Address - Country:US
Mailing Address - Phone:913-588-3891
Mailing Address - Fax:913-945-6916
Practice Address - Street 1:3901 RAINBOW BOULEVARD
Practice Address - Street 2:6067 DELP, MAIL STOP 1028
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160
Practice Address - Country:US
Practice Address - Phone:913-588-3891
Practice Address - Fax:913-945-6916
Is Sole Proprietor?:No
Enumeration Date:2007-06-11
Last Update Date:2016-12-19
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Provider Licenses
StateLicense IDTaxonomies
MI4301088031207R00000X
KS94-09080207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine