Healthcare Provider Details

I. General information

NPI: 1154749174
Provider Name (Legal Business Name): JOHN RYU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2014
Last Update Date: 10/20/2025
Certification Date: 10/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5400 KENNEDY AVE
CINCINNATI OH
45213-2664
US

IV. Provider business mailing address

5400 KENNEDY AVE
CINCINNATI OH
45213-2664
US

V. Phone/Fax

Practice location:
  • Phone: 877-776-7226
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085D0003X
TaxonomyDiagnostic Neuroimaging (Radiology) Physician
License Number35.127332
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number35.127332
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: