Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 35093747 | OH |
Y | 207RA0401X | Internist - Addiction Medicine | 35.093747 | OH |
N | 207RA0401X | Internist - Addiction Medicine | 43226 | KY |
NPI | 1073714812 |
---|---|
Provider Name | Shawn Ryan |
First Address | Cincinnati, OH 45206-2348 |
Second Address | Cincinnati, OH 45206 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2007 |
Last Update Date | 05/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2993944 | (05) | OH |
7100112350 | (05) | KY |