| Doctor Name: | RYAN H. FITZWATER |
| NPI Number: | 1770524977 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.O. |
| License Number: | 2253 |
| Business Practice Address: | 1201 Washington St E Suite 105 Charleston, WV - 253011834 |
| Business Phone Number: | 3043881965 |
| Business Fax Number: | 3043881969 |
| Mailing Address: | 415 Morris St, Suite 304 CHARLESTON |
| State: | WV |
| Postal Code: | 253011842 |
| Phone Number: | 3043887782 |
| Fax Number: | 3043887788 |
| NPI Enumeration Date: | 06/09/2006 |
| NPI Last Update Date: | 04/24/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 2253 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WV |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |