MEDICARE: DR. FRANK M. RYAN 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
1	207R00000X	Internal Medicine Physician	D0019431	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0400752	OTHER	MD	EVERCARE
2	0780385	OTHER	MH	AETNA US HEALTHCARE
3	1417045013	OTHER	MH	CIGNA
4	9711	OTHER	MD	KAISER
5	0400048	OTHER	MD	UNTD HLTHC AMERI-CHOICE
6	25970007	OTHER	DC	BCBSNCA
7	521973185	OTHER	MD	PHCS
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	498199	OTHER	MD	NCPPO
10	4053590	OTHER	MD	AETNA
11	42021409	OTHER	MD	BCBS OF MARYLAND
12	02133000000	OTHER	MH	PREFERRED HEALTH
13	256066	OTHER	MD	MAMSI/ALLIANCE
14	521973185	OTHER	MD	FIDELITY PMG
15	521973185	OTHER	MD	UNITED HEALTHCARE
16	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1427016591
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FRANK M. RYAN M.D.

Provider Business Mailing Address
First Line	:	12805 LOST LAKE CIR
Second Line	:
City	:	FORT WASHINGTON
State	:	MD
Zip	:	20744-6307
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11701 LIVINGSTON RD
Second Line	:	SUITE 103
City	:	FORT WASHINGTON
State	:	MD
Zip	:	20744-5104
Country	:	US
Telephone Number	:	301-292-7270
Fax Number	:	301-203-0740

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/01/2006
Last Update Date	:	04/02/2009

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