Provider Demographics
NPI:1285167932
Name:WHITING, RYAN ERIC (MD)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:ERIC
Last Name:WHITING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:WALTER REED NATIONAL MILITARY CTR
Mailing Address - Street 2:8901 WISCONSIN AVENUE
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20889-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:MONCRIEF ARMY HEALTH CLINIC
Practice Address - Street 2:4500 STUART AVE
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29207
Practice Address - Country:US
Practice Address - Phone:803-751-0447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-10
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE310492085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology