Provider Demographics
NPI:1053368290
Name:TORRIE, RYAN D (MD)
Entity type:Individual
Prefix:MR
First Name:RYAN
Middle Name:D
Last Name:TORRIE
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 1:1331 S A ST
Mailing Address - Street 2:
Mailing Address - City:ELWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46036-1942
Mailing Address - Country:US
Mailing Address - Phone:765-552-4600
Mailing Address - Fax:765-552-4680
Practice Address - Street 1:1331 S A ST
Practice Address - Street 2:
Practice Address - City:ELWOOD
Practice Address - State:IN
Practice Address - Zip Code:46036-1942
Practice Address - Country:US
Practice Address - Phone:765-552-4600
Practice Address - Fax:765-552-4680
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01059455207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
INI17808Medicare UPIN