Provider Demographics
NPI:1316924384
Name:RYAN, SHEILA ELLEN (MD)
Entity type:Individual
Prefix:MS
First Name:SHEILA
Middle Name:ELLEN
Last Name:RYAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:783 DOCTORS CT STE C
Mailing Address - Street 2:
Mailing Address - City:ROXBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27573-4575
Mailing Address - Country:US
Mailing Address - Phone:336-597-9200
Mailing Address - Fax:336-597-9202
Practice Address - Street 1:2609 N DUKE ST
Practice Address - Street 2:SUITE 801
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27704-3048
Practice Address - Country:US
Practice Address - Phone:919-220-2020
Practice Address - Fax:919-220-9257
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2010-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9701862207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891086PMedicaid
NCENT32OtherPRIMA
NC1086POtherBCBS
NC8436056OtherCIGNA
NC1000373OtherUHC
NC2248253DMedicare ID - Type Unspecified
NC1000373OtherUHC