Provider Demographics
NPI:1437366374
Name:BALLUM, RYAN LEE (MD)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:LEE
Last Name:BALLUM
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Gender:F
Credentials:MD
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Mailing Address - Street 1:28 WESTHAMPTON WAY, SPECIAL PROGRAMS BUILDING
Mailing Address - Street 2:UNIVERSITY OF RICHMOND STUDENT HEALTH CENTER
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23173
Mailing Address - Country:US
Mailing Address - Phone:804-289-8064
Mailing Address - Fax:804-287-6466
Practice Address - Street 1:28 WESTHAMPTON WAY, SPECIAL PROGRAMS BUILDING
Practice Address - Street 2:UNIVERSITY OF RICHMOND STUDENT HEALTH CENTER
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23173
Practice Address - Country:US
Practice Address - Phone:804-289-8064
Practice Address - Fax:804-287-6466
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2025-03-07
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Provider Licenses
StateLicense IDTaxonomies
VA0101241773208000000X, 2080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics