Individual
DR. RYAN DAVIDOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
110 29TH AVE N STE 201, NASHVILLE, TN 37203-1458
(615) 327-4304
Mailing address
110 29TH AVE N STE 201, NASHVILLE, TN 37203-1458
(615) 327-4304
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
63020
TN
207L00000X
Anesthesiology Physician
66336
WI
208D00000X
General Practice Physician
66336-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1033503412
—
WI
Enumeration date
03/24/2015
Last updated
08/12/2021
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