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NPI Code Detail

MEDICARE: DR. COURTNEY KATHERINE RYAN MD

MEDICARE: DR. COURTNEY KATHERINE RYAN MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician0101232058VA

General Provider Information

NPI Number : 1083608954
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. COURTNEY KATHERINE RYAN MD
Provider Business Mailing Address
First Line : 5645 STONE RD
Second Line :
City : CENTREVILLE
State : VA
Zip : 20120-1618
Country : US
Telephone Number : 703-266-2442
Fax Number : 703-266-7158
Provider Business Practice Location Address
First Line : 5645 STONE RD
Second Line :
City : CENTREVILLE
State : VA
Zip : 20120-1618
Country : US
Telephone Number : 703-266-2442
Fax Number : 703-266-7158
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/07/2005
Last Update Date : 03/11/2025

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Directions to “ DR. COURTNEY KATHERINE RYAN MD” Practice Location

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