Individual
DR. RYAN GARNER MIHATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 MEDICAL VILLAGE DR, EDGEWOOD, KY 41017-3403
(859) 757-2927
(859) 341-0203
Mailing address
4700 LAS VEGAS BLVD N, NELLIS AFB, NV 89191-6600
(702) 653-2273
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
01066636A
IN
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
35.120207
OH
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
C2689
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000625951
BCBS
IN
05
—
200964680
—
IN
01
—
35.120207
OH MEDICAL LIC
OH
Enumeration date
12/02/2005
Last updated
07/15/2024
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