| Michael Edward Ryan, | |
|
400 E 3rd St, Duluth, MN 55805-1951 | |
| (218) 786-8364 | |
| Not Available |
| Full Name | Michael Edward Ryan |
|---|---|
| Gender | Male |
| Speciality | Radiology - Diagnostic Radiology |
| Location | 400 E 3rd St, Duluth, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215953997 | NPI | - | NPPES |
| 365527000 | Medicaid | MN | |
| 32140800 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | 38318 (Minnesota) | Primary |
| Entity Name | Brainerd Medical Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1295801777 PECOS PAC ID: 0648270272 Enrollment ID: O20070105000140 |
| Mailing Address | Practice Location Address |
|---|---|
| Michael Edward Ryan, 400 E 3rd St, Duluth, MN 55805-1951 Ph: (218) 786-8364 | Michael Edward Ryan, 400 E 3rd St, Duluth, MN 55805-1951 Ph: (218) 786-8364 |
Bruce James Derauf, Radiology Medicare: Accepting Medicare Assignments Practice Location: 400 E 3rd St, Duluth, MN 55805 Phone: 218-786-8364 | |
Mrs. Rebecca Lynn Kuntz, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 925 E Superior St, Suite 109, Duluth, MN 55802 Phone: 218-722-3700 Fax: 218-722-8705 | |
Dr. Matthew Steven Wagner, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 420 E 1st St, Duluth, MN 55805 Phone: 218-786-8364 | |
Kenneth Dornfeld, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 400 East 3rd Street, Duluth, MN 55805 Phone: 218-786-8364 | |
Dr. William E. Johnson, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 925 E Superior St, Suite109, Duluth, MN 55802 Phone: 218-722-3700 Fax: 218-722-8705 | |
Dr. Ryan Patrick Wippler, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 420 E 1st St, Duluth, MN 55805 Phone: 218-786-8364 |