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NPI Code Detail

MEDICARE: DR. RYAN J. COLLER M.D.

MEDICARE: DR. RYAN J. COLLER 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
1208M00000XHospitalist Physician60832WI
2208000000XPediatrics Physician60832WI

General Provider Information

NPI Number : 1922279801
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RYAN J. COLLER M.D.
Provider Business Mailing Address
First Line : 7974 UW HEALTH CT
Second Line :
City : MIDDLETON
State : WI
Zip : 53562-5531
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 600 HIGHLAND AVE
Second Line : H4/4 4108
City : MADISON
State : WI
Zip : 53792-0001
Country : US
Telephone Number : 608-263-8558
Fax Number : 608-265-9243
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/18/2008
Last Update Date : 01/11/2021

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