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General NPI Number Information
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NPI Number | 1619191590
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Entity Type | Individual
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Provider Name | RYAN P STANGER M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 03/15/2012
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Provider Practice Location Address
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Address Line | 6 HAMPTONSHIRE PL SE
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City | ROME
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State | GA
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Zip | 30161-8067
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Country | US
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Telephone | 706-622-2004
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Fax |
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Provider Business Mailing Address
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Address Line | 6 HAMPTONSHIRE PL SE
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City | ROME
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State | GA
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Zip | 30161-8067
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Country | US
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Telephone | 706-622-2004
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 66081
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License Number State | GA
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