Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2084N0400X | Neurologist | 036-116801 | IL |
N | 2084N0400X | Neurologist | 13837 | NV |
Y | 2084N0400X | Neurologist | 53122 | AZ |
N | 2084N0400X | Neurologist | MD.28865 | AL |
NPI | 1013129972 |
---|---|
Provider Name | Ryan Robert Walsh |
First Address | Phoenix, AZ 85013-4407 |
Second Address | Phoenix, AZ 85013 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2007 |
Last Update Date | 19/09/2018 |