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NPI Code Detail

MEDICARE: DR. RYAN M PEIRCE M.D.

MEDICARE: DR. RYAN M PEIRCE 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
12085R0202XDiagnostic Radiology Physician036-110027IL
22085R0202XDiagnostic Radiology Physician4301088229MI
32085R0202XDiagnostic Radiology Physician50104-020WI

General Provider Information

NPI Number : 1790704724
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RYAN M PEIRCE M.D.
Provider Business Mailing Address
First Line : 2941 S RIDGE RD
Second Line :
City : GREEN BAY
State : WI
Zip : 54304-5517
Country : US
Telephone Number : 920-964-0480
Fax Number :
Provider Business Practice Location Address
First Line : 2941 S RIDGE RD
Second Line :
City : GREEN BAY
State : WI
Zip : 54304-5517
Country : US
Telephone Number : 920-964-0480
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2006
Last Update Date : 08/22/2013

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