Healthcare Provider Details

I. General information

NPI: 1275004319
Provider Name (Legal Business Name): RYAN CURTIS KORYCIAK M.D., MA, BA, TLLP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2018
Last Update Date: 01/29/2024
Certification Date: 10/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HOPE NETWORK/ NEW PASSAGE 1110 ELDON BAKER DR.
FLINT MI
48507-9622
US

IV. Provider business mailing address

3353 HOSPITAL RD
SAGINAW MI
48603-9622
US

V. Phone/Fax

Practice location:
  • Phone: 810-213-1803
  • Fax:
Mailing address:
  • Phone: 989-746-9633
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: