Healthcare Provider Details

I. General information

NPI: 1497744213
Provider Name (Legal Business Name): EDWARD K RYTER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2005
Last Update Date: 03/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

470 GRANBY ROAD SUITE 1
SOUTH HADLEY MA
01075-3218
US

IV. Provider business mailing address

280 CHESTNUT STREET 2ND FL
SPRINGFIELD MA
01199-1001
US

V. Phone/Fax

Practice location:
  • Phone: 413-533-3926
  • Fax: 413-794-8732
Mailing address:
  • Phone: 413-794-5700
  • Fax: 413-794-1629

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number80869
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: