Individual
DR. RYAN HUDSON FITZGERALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
132 RIVERSTONE TER STE 101, CANTON, GA 30114
(678) 880-0036
(404) 481-4427
Mailing address
900 CIRCLE 75 PKWY SE STE 900, ATLANTA, GA 30339-3084
(678) 426-2171
(404) 446-1957
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
POD001364
GA
213ES0103X
Foot & Ankle Surgery Podiatrist
0103301013
VA
213ES0103X
Foot & Ankle Surgery Podiatrist
626
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PD6265
—
SC
Enumeration date
05/19/2008
Last updated
01/26/2022
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