=====================================================
General NPI Number Information
=====================================================
NPI Number | 1780812933
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RYAN DAVID MILLS D.O.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/26/2009
-----------------------------------------------------
Last Update Date | 07/11/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 525 E MARKET ST
-----------------------------------------------------
City | AKRON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44304-1619
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-375-3315
-----------------------------------------------------
Fax | 330-375-7779
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 525 E MARKET ST
-----------------------------------------------------
City | AKRON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44304-1619
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-375-3315
-----------------------------------------------------
Fax | 330-375-7779
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RE0101X
-----------------------------------------------------
Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
-----------------------------------------------------
License Number | 011321
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207RC0200X
-----------------------------------------------------
Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
-----------------------------------------------------
License Number | 34011321
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------