Individual
DR. NICHOLAS RYAN CARR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
295 S CHIPETA WAY, SALT LAKE CITY, UT 84108-1287
(801) 581-7052
Mailing address
3551 ROGER BROOKE DR, JBSA FT SAM HOUSTON, TX 78234-4504
(210) 916-7078
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
0102202699
VA
2080N0001X
Neonatal-Perinatal Medicine Physician
0102202699
VA
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
11753222-1204
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/08/2009
Last updated
01/22/2024
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