Individual
RYAN BAUTISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
U
Contact information
Practice address
9300 DEWITT LOOP # O3.300, FORT BELVOIR, VA 22060-5285
(571) 231-4598
Mailing address
9300 DEWITT LOOP # O3.300, FORT BELVOIR, VA 22060-5285
Taxonomy
Speciality
Code
Description
License number
State
163WG0100X
Gastroenterology Registered Nurse
Primary
744027
CA
Other
Enumeration date
08/15/2024
Last updated
08/15/2024
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