| Ryan Thomas Fahy, DO | |
|
295 Maple St Ste 200, Tawas City, MI 48763-9352 | |
| (989) 362-0188 | |
| (989) 362-7171 |
| Full Name | Ryan Thomas Fahy |
|---|---|
| Gender | Male |
| Speciality | Surgery |
| Location | 295 Maple St Ste 200, Tawas City, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073000238 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | FF3311812 (Michigan) | Primary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
| Entity Name | Mclaren Medical Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1346396066 PECOS PAC ID: 3971416082 Enrollment ID: O20031106000025 |
| Mailing Address | Practice Location Address |
|---|---|
| Ryan Thomas Fahy, DO 4000 Wellness Dr, Midland, MI 48670-2000 Ph: (844) 832-1956 | Ryan Thomas Fahy, DO 295 Maple St Ste 200, Tawas City, MI 48763-9352 Ph: (989) 362-0188 |
Surya Sankaran, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 651 M 55 E, Tawas City, MI 48763 Phone: 989-362-8681 Fax: 989-362-3321 | |
Dr. Mark A Gallagher, D.O. Surgery Medicare: Not Enrolled in Medicare Practice Location: 295 Maple St, Suite 200, Tawas City, MI 48763 Phone: 989-984-3788 | |
Dr. Gregory A Bohn, MD Surgery Medicare: Medicare Enrolled Practice Location: 295 Maple St Ste 200, Tawas City, MI 48763 Phone: 989-984-3788 Fax: 989-984-3794 |