Provider Demographics
NPI:1205608056
Name:RYAN, DAVID M (PHARMD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:M
Last Name:RYAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1484 GOTTSCHALL RD
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:OH
Mailing Address - Zip Code:44224-3200
Mailing Address - Country:US
Mailing Address - Phone:234-716-9023
Mailing Address - Fax:
Practice Address - Street 1:2086 GRAHAM RD
Practice Address - Street 2:
Practice Address - City:STOW
Practice Address - State:OH
Practice Address - Zip Code:44224-4003
Practice Address - Country:US
Practice Address - Phone:330-688-4372
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-25
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03324174183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty