Provider Demographics
NPI:1780940593
Name:HOLSTE, RYAN P (MD)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:P
Last Name:HOLSTE
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:P O BOX 12087
Mailing Address - Street 2:PENINSULA RADIOLOGICAL ASSOCIATES
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23612-2087
Mailing Address - Country:US
Mailing Address - Phone:757-867-6101
Mailing Address - Fax:757-750-3665
Practice Address - Street 1:500 J CLYDE MORRIS BLVD
Practice Address - Street 2:RIVERSIDE REGIONAL MEDICAL CENTER
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23601-1929
Practice Address - Country:US
Practice Address - Phone:757-612-6999
Practice Address - Fax:757-750-3665
Is Sole Proprietor?:No
Enumeration Date:2012-04-05
Last Update Date:2018-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012632682085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology