Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 80379 | GA |
NPI | 1053601807 |
---|---|
Provider Name | Ryan Jewell Schlueter |
First Address | Atlanta, GA 30308-2240 |
Second Address | Atlanta, GA 30308-2240 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2011 |
Last Update Date | 30/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
003207084 | (05) | GA |