Healthcare Provider Details

I. General information

NPI: 1366603516
Provider Name (Legal Business Name): RYAN SCOTT NAGY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2008
Last Update Date: 11/01/2021
Certification Date: 11/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

196 COLONIAL DR
YOUNGSTOWN OH
44505-2139
US

IV. Provider business mailing address

7031 BARRINGTON DR
CANFIELD OH
44406-7634
US

V. Phone/Fax

Practice location:
  • Phone: 833-720-6249
  • Fax:
Mailing address:
  • Phone: 833-720-6249
  • Fax: 833-720-6249

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number4301092681
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number4301092681
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4301092681
License Number StateMI
# 4
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number099065
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: