Provider Demographics
NPI:1912984105
Name:RYCKMAN, CHRISTOPHER SHERIDAN (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:SHERIDAN
Last Name:RYCKMAN
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 1:110 N EWING ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-3307
Mailing Address - Country:US
Mailing Address - Phone:740-687-5864
Mailing Address - Fax:
Practice Address - Street 1:110 N EWING ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-3307
Practice Address - Country:US
Practice Address - Phone:740-687-5864
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH048474207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Not Answered207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH08991010OtherBWC
OH0628306Medicaid
OHRY0583442Medicare ID - Type Unspecified
OH0628306Medicaid