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General NPI Number Information
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NPI Number | 1861691776
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Entity Type | Individual
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Provider Name | RYAN J GUNSELMAN MD
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Gender | Male
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Dates
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Enumeration Date | 07/12/2007
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Last Update Date | 09/17/2024
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Provider Practice Location Address
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Address Line | 22 BRAMHALL ST
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City | PORTLAND
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State | ME
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Zip | 04102-3134
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Country | US
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Telephone | 207-662-2526
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Fax | 207-662-6236
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Provider Business Mailing Address
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Address Line | 324 GANNETT DR STE 200
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City | SOUTH PORTLAND
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State | ME
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Zip | 04106-3266
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Country | US
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Telephone | 207-482-7800
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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 | 57012163
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 32489
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | MD28401
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License Number State | ME
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