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Individual

MR. RYAN M. CARLSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
1933 OHIO DRIVE, GROVE CITY, OH 43123-4835
(614) 277-9530
(614) 277-2227
Mailing address
5720 BLAZER PARKWAY, DUBLIN, OH 43017-3566
(614) 761-1151
(614) 761-4893

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
34.009281
OH
207N00000X
Dermatology Physician
5101016570
MI
207NS0135X
Procedural Dermatology Physician
34.009281
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2851301
OH
Enumeration date
04/10/2007
Last updated
03/04/2015
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