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Individual

RYAN H. FITZWATER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
1201 WASHINGTON ST E, SUITE 105, CHARLESTON, WV 25301-1834
(304) 388-1965
(304) 388-1969
Mailing address
415 MORRIS ST, SUITE 304, CHARLESTON, WV 25301-1842
(304) 388-7782
(304) 388-7788

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
2253
WV
208D00000X
General Practice Physician
2253
WV
363A00000X
Physician Assistant

Other

Enumeration date
06/09/2006
Last updated
04/24/2012
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