Provider Demographics
NPI:1518221704
Name:NOLTE, RYAN NICHOLAS (MD)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:NICHOLAS
Last Name:NOLTE
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Gender:M
Credentials:MD
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Mailing Address - Street 1:839 INMAN VILLAGE PKWY NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30307-5501
Mailing Address - Country:US
Mailing Address - Phone:251-689-2906
Mailing Address - Fax:217-545-2563
Practice Address - Street 1:711 CANTON RD NE STE 220
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-8949
Practice Address - Country:US
Practice Address - Phone:404-554-2196
Practice Address - Fax:404-554-2415
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-02
Last Update Date:2020-11-12
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Provider Licenses
StateLicense IDTaxonomies
GA867212086S0129X
IL0361438342086S0129X
FLME1471102086S0129X
IL125.0614342086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery