Healthcare Provider Details

I. General information

NPI: 1902984255
Provider Name (Legal Business Name): MARIANNE THERESA RITCHIE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 01/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

132 S. 10TH STREET 480 MAIN BLDG.
PHILA PA
19107
US

IV. Provider business mailing address

132 S. 10TH STREET 480 MAIN BLDG.
PHILA PA
19107
US

V. Phone/Fax

Practice location:
  • Phone: 215-955-8900
  • Fax: 215-955-5245
Mailing address:
  • Phone: 215-955-8900
  • Fax: 215-955-5245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberMD026713E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: