Healthcare Provider Details

I. General information

NPI: 1518356609
Provider Name (Legal Business Name): RYAN YANG DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/13/2015
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 N ORANGE ST STE 7716
WILMINGTON DE
19801-1155
US

IV. Provider business mailing address

2901 RICHMOND RD STE 140-155
LEXINGTON KY
40509-1771
US

V. Phone/Fax

Practice location:
  • Phone: 302-603-1005
  • Fax: 302-546-5700
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberH0094339
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036160620
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberC2-0024053
License Number StateDE
# 4
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberC0745
License Number StateKY
# 5
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDOS-1911
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: