Provider Demographics
NPI:1649698523
Name:SANTIN, RYAN THOMAS (MD)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:THOMAS
Last Name:SANTIN
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 1:2221 S 17TH ST STE 202
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68502-3763
Mailing Address - Country:US
Mailing Address - Phone:402-483-8555
Mailing Address - Fax:402-483-8554
Practice Address - Street 1:2221 S 17TH ST STE 202
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68502-3763
Practice Address - Country:US
Practice Address - Phone:402-483-8555
Practice Address - Fax:402-483-8554
Is Sole Proprietor?:No
Enumeration Date:2014-03-28
Last Update Date:2020-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
ND143262084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program