Provider Demographics
NPI:1053601807
Name:SCHLUETER, RYAN JEWELL (DO)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:JEWELL
Last Name:SCHLUETER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 PEACHTREE ST NE STE 1275
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-2240
Mailing Address - Country:US
Mailing Address - Phone:404-872-3121
Mailing Address - Fax:404-334-4686
Practice Address - Street 1:550 PEACHTREE ST NE STE 1275
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-2240
Practice Address - Country:US
Practice Address - Phone:404-872-3121
Practice Address - Fax:404-334-4686
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-13
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA80379207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003207084Medicaid