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Contact Information

RYAN H FITZGERALD, DPM
132 RIVERSTONE TER STE 101
CANTON, GA30114
 Phone: 678-880-0036
 Fax: 404-481-4427
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
 

Surgery, Foot & Ankle

213ES0103X 48 Podiatry
Indicates primary specialty

NPI Profile & details for RYAN H FITZGERALD · (Male)

NPI # 1760649602
Status Active
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 05/19/2008
Last updated 01/26/2022 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • GA License # POD001364
  • SC License # 626
  • VA License # 0103301013
  • SC Medicaid PD6265
Hospital affiliation(s)
  • WELLSTAR KENNESTONE HOSPITAL - (Acute Care)
    677 CHURCH STREET
    MARIETTA, GA 30060
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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