Provider Demographics
NPI:1093784001
Name:CANTZLER, RYAN M (MD)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:M
Last Name:CANTZLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:6785 HAYHURST ST
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-2527
Mailing Address - Country:US
Mailing Address - Phone:248-953-0434
Mailing Address - Fax:
Practice Address - Street 1:750 MOUNT CARMEL MALL
Practice Address - Street 2:SUITE 300
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43222-1553
Practice Address - Country:US
Practice Address - Phone:614-224-6420
Practice Address - Fax:614-224-6423
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35086485207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
I34827Medicare UPIN