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Individual

RYAN PATRICK FAGAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D., M.P.H.

Contact information

Practice address
1600 CLIFTON ROAD NE, BUILDING 1, MS D-63, ATLANTA, GA 30333
(404) 708-1154
(404) 639-3535
Mailing address
1600 CLIFTON ROAD NE, BUILDING 1, MS D-63, ATLANTA, GA 30333
(404) 708-1154
(404) 639-3535

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD.15556R
LA
207RI0200X
Infectious Disease Physician
Primary
MD.15556R
LA

Other

Enumeration date
12/10/2008
Last updated
12/10/2008
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