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General NPI Number Information
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NPI Number | 1639106537
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Entity Type | Individual
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Provider Name | MARTIN T RYAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/27/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5354 N HIGH ST FIRST FLOOR
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City | COLUMBUS
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State | OH
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Zip | 43214-1295
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Country | US
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Telephone | 740-803-4332
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Fax | 888-210-4572
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Provider Business Mailing Address
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Address Line | 95 ELIZABETH ST SUITE 108
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City | DELAWARE
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State | OH
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Zip | 43015-2358
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Country | US
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Telephone | 740-369-0020
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Fax | 888-210-4572
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 35065539
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License Number State | OH
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