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Organization
BAYSIDE PODIATRY P.A.
Active
Organization
BAYSIDE PODIATRY P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUSSELL JOHN RYBKA DPM (PRESIDENT/ OWNER)
(207) 829-6463
Entity
Organization
Contact information
Practice address
326 MAIN ST, CUMBERLAND CENTER, ME 04021-3904
(207) 829-6463
(207) 829-6513
Mailing address
326 MAIN ST, PO BOX 125, CUMBERLAND CENTER, ME 04021-3904
(207) 829-6463
(207) 829-6513
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
POD233
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
212590000
—
ME
Enumeration date
04/21/2010
Last updated
04/21/2010
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