Healthcare Provider Details

I. General information

NPI: 1588825236
Provider Name (Legal Business Name): CATHERINE RIDINGS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2008
Last Update Date: 03/10/2022
Certification Date: 02/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

JOHN H. BRADLEY BRANCH HEALTH CLINIC BUILDING 5003, 2189 ELROD RD.
QUANTICO VA
22134
US

IV. Provider business mailing address

JOHN H. BRADLEY BRANCH HEALTH CLINIC BUILDING 5003, 2189 ELROD RD.
QUANTICO VA
22134
US

V. Phone/Fax

Practice location:
  • Phone: 703-432-6260
  • Fax:
Mailing address:
  • Phone: 703-432-6260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number25331
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: