Healthcare Provider Details

I. General information

NPI: 1093856403
Provider Name (Legal Business Name): FRANK MATTHEW RYAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2007
Last Update Date: 01/18/2022
Certification Date: 01/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 NO. 16TH ST.
NEW CASTLE IN
47362-4319
US

IV. Provider business mailing address

PO BOX 485
NEW CASTLE IN
47362-0485
US

V. Phone/Fax

Practice location:
  • Phone: 765-599-3494
  • Fax: 765-521-1331
Mailing address:
  • Phone: 765-599-3493
  • Fax: 765-521-1331

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number01063417A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: