Individual
DR. RYAN GLENN HARTIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4666 W JEFFERSON BLVD STE 170, FORT WAYNE, IN 46804-6893
(260) 207-4137
Mailing address
4666 W JEFFERSON BLVD STE 170, FORT WAYNE, IN 46804-6893
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
01076905A
IN
Other
Enumeration date
09/25/2013
Last updated
02/21/2025
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