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General NPI Number Information
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NPI Number | 1114040516
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Entity Type | Individual
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Provider Name | PATRICK THOMAS RYAN MD
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Gender | Male
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Dates
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Enumeration Date | 04/09/2007
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Last Update Date | 10/08/2025
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Provider Practice Location Address
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Address Line | 222 HERLONG AVE S
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City | ROCK HILL
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State | SC
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Zip | 29732-1158
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Country | US
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Telephone | 803-329-1234
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Fax |
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Provider Business Mailing Address
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Address Line | 222 HERLONG AVE S
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City | ROCK HILL
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State | SC
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Zip | 29732-1158
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Country | US
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Telephone | 803-329-1234
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 61999
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 2025-03462
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 22580
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License Number State | WV
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 22580
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License Number State | WV
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