Provider Demographics
NPI:1023202728
Name:GASSER, RYAN MITCHEL (MD)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:MITCHEL
Last Name:GASSER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4760 BELPAR ST NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-3603
Mailing Address - Country:US
Mailing Address - Phone:330-492-9200
Mailing Address - Fax:
Practice Address - Street 1:224 W EXCHANGE ST
Practice Address - Street 2:#440
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44302-1704
Practice Address - Country:US
Practice Address - Phone:330-344-2663
Practice Address - Fax:330-344-6038
Is Sole Proprietor?:No
Enumeration Date:2007-09-05
Last Update Date:2017-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-120709207X00000X, 207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2551671OtherPARTNERS PHYSICIAN GROUP MEDICAID GROUP #
OH9338635OtherPARTNERS PHYSICIAN GROUP MEDICARE GROUP #
OH0080863Medicaid
OH1841239274OtherPARTNERS PHYSICIAN GROUP TYPE 2 NPI #
OH1841239274OtherPARTNERS PHYSICIAN GROUP TYPE 2 NPI #