Healthcare Provider Details

I. General information

NPI: 1427045160
Provider Name (Legal Business Name): FREDERICK BEEMAN RUYMANN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2005
Last Update Date: 11/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 S 18TH ST
COLUMBUS OH
43205-2654
US

IV. Provider business mailing address

555 S 18TH ST
COLUMBUS OH
43205-2654
US

V. Phone/Fax

Practice location:
  • Phone: 614-722-3552
  • Fax: 614-722-3699
Mailing address:
  • Phone: 614-722-3552
  • Fax: 614-722-3699

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number35048172
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: