Provider Demographics
NPI:1588133599
Name:FRYMAN INTERNAL MEDICINE LLC
Entity type:Organization
Organization Name:FRYMAN INTERNAL MEDICINE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FRYMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:419-367-8688
Mailing Address - Street 1:5188 BLESSING CT
Mailing Address - Street 2:
Mailing Address - City:GALENA
Mailing Address - State:OH
Mailing Address - Zip Code:43021-8142
Mailing Address - Country:US
Mailing Address - Phone:419-367-8688
Mailing Address - Fax:614-766-5264
Practice Address - Street 1:2715 SAWBURY BLVD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235-4583
Practice Address - Country:US
Practice Address - Phone:614-766-5211
Practice Address - Fax:614-766-5264
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-19
Last Update Date:2019-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility