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NPI Code Detail

MEDICARE: JOHN P. RYAN M.D.

MEDICARE:   JOHN P. 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
1208000000XPediatrics Physician21475NH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1487016622
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN P. RYAN M.D.
Provider Business Mailing Address
First Line : 330 BORTHWICK AVE STE 101
Second Line :
City : PORTSMOUTH
State : NH
Zip : 03801-4102
Country : US
Telephone Number : 603-436-7171
Fax Number : 508-334-1977
Provider Business Practice Location Address
First Line : 330 BORTHWICK AVE STE 101
Second Line :
City : PORTSMOUTH
State : NH
Zip : 03801-4102
Country : US
Telephone Number : 603-436-7171
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2016
Last Update Date : 07/30/2021

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Directions to “ JOHN P. RYAN M.D.” Practice Location

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