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General NPI Number Information
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NPI Number | 1154701282
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Entity Type | Individual
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Provider Name | RYAN BAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/03/2015
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Last Update Date | 08/23/2018
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Provider Practice Location Address
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Address Line | 1925 WOODWINDS DR
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City | WOODBURY
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State | MN
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Zip | 55125
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Country | US
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Telephone | 651-232-0395
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Fax |
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Provider Business Mailing Address
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Address Line | 1925 WOODWINDS DR
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City | WOODBURY
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State | MN
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Zip | 55125-4445
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Country | US
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Telephone |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | LL38233
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License Number State | SC
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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 | 64494
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License Number State | MN
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