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General NPI Number Information
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NPI Number | 1720906233
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Entity Type | Individual
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Provider Name | RYAN FIELDMAN PRSS
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Gender | Male
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Dates
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Enumeration Date | 07/10/2026
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Last Update Date | 07/10/2026
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Provider Practice Location Address
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Address Line | 25208 GEORGE WASHINGTON HWY
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City | AURORA
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State | WV
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Zip | 26705-8036
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Country | US
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Telephone | 304-239-1214
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Fax | 304-735-3620
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Provider Business Mailing Address
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Address Line | 124 FOUNTAIN VW
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City | MORGANTOWN
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State | WV
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Zip | 26505-3849
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Country | US
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Telephone | 304-239-1214
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Fax | 304-735-3620
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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 | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number | 18-900
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License Number State | WV
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