Ryan Kaiponen
Individual provider Active NPI Pharmacist · Ontonagon, MI
NPI 1508397993 · NPPES record last updated Mar 27, 2017
Key facts
- NPI
- 1508397993
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 5302041935 (MI)
- Practice address
- 118 Cherry LN
Ontonagon, MI 49953-9723 - Phone
- (906) 390-0301
- NPI assigned
- Mar 27, 2017
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302041935 | MI | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302041935 | MI | Yes |
Addresses
Primary practice location
118 Cherry LN
Ontonagon, MI 49953-9723
Mailing address
118 Cherry LN
Ontonagon, MI 49953-9723
Phone (906) 390-0301
Other providers in Ontonagon, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 27, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.