MEDICARE: ADAM RYAN HENN MD

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	2085R0202X	Diagnostic Radiology Physician	2002-00231	NC
2	2085R0204X	Vascular & Interventional Radiology Physician	2002-00231	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	1310Y	OTHER	NC	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275532798
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADAM RYAN HENN MD

Provider Business Mailing Address
First Line	:	PO BOX 85378
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60689-5378
Country	:	US
Telephone Number	:	336-274-6682
Fax Number	:	336-274-8097

Provider Business Practice Location Address
First Line	:	1331 N ELM ST STE 200
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27401-6304
Country	:	US
Telephone Number	:	336-274-6682
Fax Number	:	336-274-8097

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2005
Last Update Date	:	09/30/2025

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Directions to “ ADAM RYAN HENN MD” Practice Location

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