Healthcare Provider Details

I. General information

NPI: 1922257146
Provider Name (Legal Business Name): SIMON ALEXANDER RITCHIE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2008
Last Update Date: 05/27/2025
Certification Date: 05/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1060 W PERIMETER RD
JB ANDREWS MD
20762-6602
US

IV. Provider business mailing address

2093 PHILADELPHIA PIKE # 2696
CLAYMONT DE
19703-2424
US

V. Phone/Fax

Practice location:
  • Phone: 218-228-0904
  • Fax: 218-228-0904
Mailing address:
  • Phone:
  • Fax: 218-228-0904

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License NumberP8407
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberP8407
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: