Provider Demographics
NPI:1417485160
Name:SARVER, RYAN M (MD)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:M
Last Name:SARVER
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:SCHNECK PRIMARY CARE - JACKSON PARK
Mailing Address - Street 2:1124 MEDICAL PLACE
Mailing Address - City:SEYMOUR
Mailing Address - State:IN
Mailing Address - Zip Code:47274
Mailing Address - Country:US
Mailing Address - Phone:812-522-1613
Mailing Address - Fax:812-522-6694
Practice Address - Street 1:SCHNECK PRIMARY CARE - JACKSON PARK
Practice Address - Street 2:1124 MEDICAL PLACE
Practice Address - City:SEYMOUR
Practice Address - State:IN
Practice Address - Zip Code:47274
Practice Address - Country:US
Practice Address - Phone:812-522-1613
Practice Address - Fax:812-522-6694
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-25
Last Update Date:2020-07-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01083929A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMT213568OtherSTATE