MEDICARE: DANIEL Y RYU 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	2083P0500X	Preventive Medicine/Occupational Environmental Medicine Physician	35-067499	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972593309
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL Y RYU MD

Provider Business Mailing Address
First Line	:	6935 TREELINE DR
Second Line	:	STE J
City	:	BRECKSVILLE
State	:	OH
Zip	:	44141-3393
Country	:	US
Telephone Number	:	440-746-2220
Fax Number	:	440-746-3496

Provider Business Practice Location Address
First Line	:	2322 E 22ND ST
Second Line	:	SVCH OCCUPATIONAL MEDICINE
City	:	CLEVELAND
State	:	OH
Zip	:	44115-3176
Country	:	US
Telephone Number	:	216-363-2691
Fax Number	:	216-694-4665

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

Provider Enumeration Date	:	10/26/2005
Last Update Date	:	01/11/2008

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