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NPI Code Detail

MEDICARE: JOSEPH EDWARD RYAN

MEDICARE: JOSEPH EDWARD RYAN
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
1175T00000XPeer Specialist25-9155WV

General Provider Information

NPI Number : 1720940265
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSEPH EDWARD RYAN
Provider Business Mailing Address
First Line : 2333 MACCORKLE AVE
Second Line :
City : SAINT ALBANS
State : WV
Zip : 25177-2073
Country : US
Telephone Number : 304-766-0060
Fax Number :
Provider Business Practice Location Address
First Line : 2333 MACCORKLE AVE
Second Line :
City : SAINT ALBANS
State : WV
Zip : 25177-2073
Country : US
Telephone Number : 304-766-0060
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2025
Last Update Date : 12/02/2025

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Directions to “ JOSEPH EDWARD RYAN ” Practice Location

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