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General NPI Number Information
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NPI Number | 1235577065
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Entity Type | Individual
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Provider Name | RYAN WILLIAM PAPPAS D.O.
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Gender | Male
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Dates
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Enumeration Date | 06/14/2013
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Last Update Date | 09/18/2020
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Provider Practice Location Address
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Address Line | 2000 ROOSEVELT RD STE 207
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City | VALPARAISO
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State | IN
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Zip | 46383-2802
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Country | US
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Telephone | 844-774-3627
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Fax | 219-364-3616
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Provider Business Mailing Address
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Address Line | 2022 KELLE DR
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City | CHESTERTON
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State | IN
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Zip | 46304-8708
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Country | US
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Telephone | 219-364-3616
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Fax | 219-364-3610
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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 | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 02005729A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 036-139830
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 2018015288
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License Number State | MO
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Taxonomy #4
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Taxonomy Code | 2084N0600X
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Taxonomy Name | Clinical Neurophysiology Physician
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License Number | 02005729A
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License Number State | IN
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