Ryan R. Pine, M.d. Ltd

NPI #1700139110 in Charleston, Illinois

Provider Information

NPI Number: 1700139110
Entity Type: Organization
Organization Name: Ryan R. Pine, M.d. Ltd
Primary Specialty: Specialist
Enumeration Date: Oct 23, 2012
Last Updated: Dec 13, 2012

Practice Location

Address: 1605 REYNOLDS DR
City: Charleston
State: Illinois
ZIP Code: 61920-3152
Phone: (217) 348-0221

Authorized Official

Name: DR. RYAN R. PINE, M.D.
Title: OWNER
Phone: (217) 348-0221

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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