Healthcare Provider Details

I. General information

NPI: 1710201256
Provider Name (Legal Business Name): MICHAEL RYAN KESSEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2010
Last Update Date: 11/25/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5501 FAR HILLS AVE STE 200
DAYTON OH
45429-2203
US

IV. Provider business mailing address

PO BOX 933432
CLEVELAND OH
44193-0039
US

V. Phone/Fax

Practice location:
  • Phone: 937-436-2866
  • Fax: 937-436-1468
Mailing address:
  • Phone: 937-641-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35.123707
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: