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General NPI Number Information
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NPI Number | 1316441066
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Entity Type | Individual
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Provider Name | RYAN KARMOUTA MD, MBA
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Gender | Male
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Dates
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Enumeration Date | 03/19/2018
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Last Update Date | 11/14/2024
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Provider Practice Location Address
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Address Line | 31 STILES RD STE 2100
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City | SALEM
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State | NH
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Zip | 03079-3035
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Country | US
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Telephone | 603-942-2020
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Fax | 603-288-1722
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Provider Business Mailing Address
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Address Line | 111 NEW HAMPSHIRE AVE STE 2
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City | PORTSMOUTH
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State | NH
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Zip | 03801-2864
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Country | US
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Telephone | 802-909-2053
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 318928
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | MD479452
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | MD26935
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License Number State | ME
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Taxonomy #4
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 22327
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License Number State | NH
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