Individual
DR. RYAN C SIDEBOTTOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
161 GENESEE ST STE 106, AUBURN, NY 13021-3390
(315) 567-0555
(315) 567-0308
Mailing address
17 LANSING ST, ATT: M.ROBERTS, AUBURN, NY 13021-1983
(315) 567-0480
(315) 255-7099
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
280950
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04198454
—
NY
Enumeration date
07/14/2010
Last updated
04/16/2018
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