Ouillette, Ryan Matthew

Ouillette, Ryan Matthew is an individual health care provider with primary practice located at 23550 Park St Ste 100, Dearborn MI 48124-2592. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Ouillette, Ryan Matthew can be contacted via phone (313) 730-0500.

Contact Information

Primary practice address
23550 Park St Ste 100 Dearborn MI 48124-2592
Phone: (313) 730-0500
Fax: (313) 730-0606
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X 4301111844 Michigan

Profile Details

NPI number 1750643235
LBN Legal business name Ouillette, Ryan Matthew
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 12th, 2012
Last updated Feb 18th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750643235 NPPES
Michigan Other 4301111844 MICHIGAN BUREAU OF PROFESSIONAL LICENSING

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