MEDICARE: RYAN ADELL MD INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1104751080
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RYAN ADELL MD INC

Provider Business Mailing Address
First Line	:	200 NORTH VINEYARD BLVD
Second Line	:	SUITE A325 UNIT 543
City	:	HONOLULU
State	:	HI
Zip	:	96817
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 NORTH VINEYARD BLVD
Second Line	:	STE A325 BOX 543
City	:	HONOLULU
State	:	HI
Zip	:	96817
Country	:	US
Telephone Number	:	440-289-8981
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	RYAN S ADELL
Credential	:	MD
Telephone Number	:	440-289-8981

Provider Enumeration Date	:	06/15/2026
Last Update Date	:	06/17/2026

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