Healthcare Provider Details
I. General information
NPI: 1326985896
Provider Name (Legal Business Name): SERI RYU PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/01/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3915 JOHNS CREEK CT STE 100
SUWANEE GA
30024-6674
US
IV. Provider business mailing address
140 SWEETEN CREEK RD
ASHEVILLE NC
28803-1526
US
V. Phone/Fax
- Phone: 770-237-3000
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363AM0700X |
| Taxonomy | Medical Physician Assistant |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: