Healthcare Provider Details

I. General information

NPI: 1750968913
Provider Name (Legal Business Name): RYAN HUNTER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2021
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 EXECUTIVE PARK DR NE
ATLANTA GA
30329-2206
US

IV. Provider business mailing address

12 EXECUTIVE PARK DR NE
ATLANTA GA
30329-2206
US

V. Phone/Fax

Practice location:
  • Phone: 404-778-3444
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number111906
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberUO7924
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberUO7924
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: