MEDICARE: MRS. SARAH A. RYAN MD

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	208800000X	Urology Physician	127435	MT
2	2088F0040X	Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician	127435	MT
3	2088F0040X	Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician	15436	NV
4	208800000X	Urology Physician	15436	NV

General Provider Information

NPI Number	:	1659328391
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SARAH A. RYAN MD

Provider Business Mailing Address
First Line	:	PO BOX 35380
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89133-5380
Country	:	US
Telephone Number	:	702-877-0814
Fax Number	:	702-877-0113

Provider Business Practice Location Address
First Line	:	2010 WELLNESS WAY STE 200
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89106-4142
Country	:	US
Telephone Number	:	702-877-0814
Fax Number	:	702-877-0113

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/28/2006
Last Update Date	:	08/26/2024

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