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NPI Code Detail

MEDICARE: RYAN CEPHAS MD

MEDICARE: RYAN CEPHAS MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0804XChild & Adolescent Psychiatry PhysicianD0103743MD
22084N0400XNeurology PhysicianD0103743MD

General Provider Information

NPI Number : 1396277125
Entity Type Code : Individual
Provider Name (Legal Business Name) : RYAN CEPHAS MD
Provider Business Mailing Address
First Line : 501 S CHIPETA WAY
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84108-1222
Country : US
Telephone Number : 801-581-7951
Fax Number :
Provider Business Practice Location Address
First Line : 8040 GEORGIA AVE STE 170
Second Line :
City : SILVER SPRING
State : MD
Zip : 20910-4959
Country : US
Telephone Number : 202-360-4787
Fax Number : 202-360-4787
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2017
Last Update Date : 02/06/2026

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