Provider Demographics
NPI:1831920792
Name:RYAN, WILLIAM M
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:M
Last Name:RYAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8410 CHESAPEAKE DR
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44067-1887
Mailing Address - Country:US
Mailing Address - Phone:330-329-9085
Mailing Address - Fax:
Practice Address - Street 1:8410 CHESAPEAKE DR
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:OH
Practice Address - Zip Code:44067-1887
Practice Address - Country:US
Practice Address - Phone:330-329-9085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH219OHHN251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health