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NPI Code Detail

MEDICARE: DR. RAYAN ELIZABETH IHLE M.D.

MEDICARE: DR. RAYAN ELIZABETH IHLE M.D.
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
1207RP1001XPulmonary Disease Physician24914WV
2207RC0200XCritical Care Medicine (Internal Medicine) Physician24914WV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
242860OTHERKYKENTUCKY BOARD OF MEDICAL LICENSURE

General Provider Information

NPI Number : 1285844159
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RAYAN ELIZABETH IHLE M.D.
Provider Business Mailing Address
First Line : 3100 MACCORKLE AVE SE STE 205
Second Line :
City : CHARLESTON
State : WV
Zip : 25304-1228
Country : US
Telephone Number : 304-388-2303
Fax Number : 304-388-2390
Provider Business Practice Location Address
First Line : 3100 MACCORKLE AVE SE STE 205
Second Line :
City : CHARLESTON
State : WV
Zip : 25304-1228
Country : US
Telephone Number : 304-720-7305
Fax Number : 304-720-7310
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2007
Last Update Date : 06/08/2020

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