Provider Demographics
NPI:1174516553
Name:NEWELL, RYAN D (DO)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:D
Last Name:NEWELL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:252 RURAL ACRES DR
Mailing Address - Street 2:
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801-3503
Mailing Address - Country:US
Mailing Address - Phone:304-253-2638
Mailing Address - Fax:304-252-1720
Practice Address - Street 1:5493 MAPLE LN
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:WV
Practice Address - Zip Code:25840-6872
Practice Address - Country:US
Practice Address - Phone:304-469-3334
Practice Address - Fax:304-465-1735
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1821207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV080188848OtherRAILROAD MEDICARE
WA001723050OtherMOUNTAIN STATE BCBS
WV7795367OtherAETNA PIN
WVH29077OtherMEDICARE UPIN
WV1802931000Medicaid
WV2172766OtherUNITED HEALTHCARE-FFS
WVP00445648OtherTRAVELERS MEDICARE
WV744504OtherCARELINK COMMERCIAL
WV286060OtherMAMSI AND OPTIMUM CHOICE
WV513906OtherRURAL HEALTH PROVIDER NO
WV1802931000Medicaid
WVH29077OtherMEDICARE UPIN
WV4038292Medicare PIN