MEDICARE: RYAN BOZOF MD PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1588553721
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RYAN BOZOF MD PC

Provider Business Mailing Address
First Line	:	7055 LAUREL OAK DR
Second Line	:
City	:	SUWANEE
State	:	GA
Zip	:	30024-5352
Country	:	US
Telephone Number	:	44-643-9578
Fax Number	:

Provider Business Practice Location Address
First Line	:	2702 ABBEY CT
Second Line	:
City	:	ALPHARETTA
State	:	GA
Zip	:	30004-6024
Country	:	US
Telephone Number	:	770-772-9195
Fax Number	:

Authorized Official
Title or Position	:	OWNER / PHYSICIAN
Name	:	RYAN GREGORY BOZOF
Credential	:	MD
Telephone Number	:	770-772-9195

Provider Enumeration Date	:	07/01/2025
Last Update Date	:	07/01/2025

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