Healthcare Provider Details

I. General information

NPI: 1629175971
Provider Name (Legal Business Name): RYAN CHRISTOPHER SHEFFIELD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 10/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 MDOS/SGOL UNIT 5142
KADENA AB APO, AP
96368
JP

IV. Provider business mailing address

PSC 80 BOX 16801
APO AP
96367-0069
US

V. Phone/Fax

Practice location:
  • Phone: 011816117304060
  • Fax:
Mailing address:
  • Phone: 01181989820408
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number23438
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: