MEDICARE: RYAN THOMAS SANKOVIC 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
1	208VP0014X	Interventional Pain Medicine Physician	35152864	OH
2	2081P2900X	Pain Medicine (Physical Medicine & Rehabilitation) Physician	35152864	OH

General Provider Information

NPI Number	:	1790270916
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RYAN THOMAS SANKOVIC MD

Provider Business Mailing Address
First Line	:	400 TOWN CENTER AVE
Second Line	:
City	:	COLUMBIANA
State	:	OH
Zip	:	44408-8312
Country	:	US
Telephone Number	:	330-482-3762
Fax Number	:	330-482-3840

Provider Business Practice Location Address
First Line	:	400 TOWN CENTER AVE
Second Line	:
City	:	COLUMBIANA
State	:	OH
Zip	:	44408-8312
Country	:	US
Telephone Number	:	330-482-3762
Fax Number	:	330-482-3840

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/29/2018
Last Update Date	:	06/25/2025

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