Provider Demographics
NPI:1861545766
Name:KRETZER, RYAN MICHAEL (MD)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:MICHAEL
Last Name:KRETZER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6567 E CARONDELET DR
Mailing Address - Street 2:SUITE 305
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85710-6152
Mailing Address - Country:US
Mailing Address - Phone:520-881-8400
Mailing Address - Fax:520-881-6563
Practice Address - Street 1:6567 E CARONDELET DR
Practice Address - Street 2:SUITE 305
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-6152
Practice Address - Country:US
Practice Address - Phone:520-881-8400
Practice Address - Fax:520-881-6563
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2013-02-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDP19038207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery