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General NPI Number Information
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NPI Number | 1093755373
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Entity Type | Individual
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Provider Name | RYAN S D CARVALHO MD
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Gender | Male
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Dates
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Enumeration Date | 06/07/2006
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Last Update Date | 07/09/2009
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Provider Practice Location Address
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Address Line | 555 S 18TH ST
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City | COLUMBUS
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State | OH
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Zip | 43205-2654
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Country | US
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Telephone | 614-722-3457
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Fax | 614-722-3454
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Provider Business Mailing Address
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Address Line | 555 S 18TH ST
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City | COLUMBUS
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State | OH
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Zip | 43205-2654
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Country | US
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Telephone | 614-722-3457
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Fax | 614-722-3454
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0206X
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Taxonomy Name | Pediatric Gastroenterology Physician
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License Number | 35087750
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License Number State | OH
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