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General NPI Number Information
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NPI Number | 1134173701
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Entity Type | Individual
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Provider Name | RYAN R RISTOW MD
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Gender | Male
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Dates
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Enumeration Date | 05/19/2006
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Last Update Date | 04/26/2013
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Provider Practice Location Address
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Address Line | 575 COPELAND MILL RD SUITE 1D
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City | WESTERVILLE
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State | OH
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Zip | 43081-8977
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Country | US
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Telephone | 614-794-3663
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Fax |
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Provider Business Mailing Address
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Address Line | 2471 ALUM CROSSING DR
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City | LEWIS CENTER
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State | OH
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Zip | 43035-7357
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Country | US
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Telephone | 614-323-8337
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Fax |
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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 | 35083945
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 39733
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD2005-0521
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License Number State | NM
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2005-01654
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License Number State | NC
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Taxonomy #5
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD26041
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License Number State | OR
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Taxonomy #6
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 12288
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License Number State | NV
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Taxonomy #7
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD00047593
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License Number State | WA
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