# RYAN FILLMORE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1184043283
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2084A2900X | Neurocritical Care Physician | 155465 | CA | — |
| 2084A2900X | Neurocritical Care Physician | 2021-01709 | NC | Yes |
| 2084N0400X | Neurology Physician | 2021-01709 | NC | — |
| 2084N0600X | Clinical Neurophysiology Physician | 2021-01709 | NC | — |

## Other

- **Enumeration date:** 04/16/2014
- **Last updated:** 02/14/2023