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General NPI Number Information
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NPI Number | 1134130131
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Entity Type | Individual
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Provider Name | DAVID NATHANIEL ARTHUR RYAN D.O.
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Gender | Male
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Dates
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Enumeration Date | 08/11/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 557 W 2600 S
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City | BOUNTIFUL
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State | UT
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Zip | 84010-7717
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Country | US
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Telephone | 801-298-9155
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Fax | 801-298-9156
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Provider Business Mailing Address
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Address Line | 557 W 2600 S
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City | BOUNTIFUL
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State | UT
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Zip | 84010-7717
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Country | US
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Telephone | 801-298-9155
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Fax | 801-298-9156
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | DO1000
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License Number State | AL
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