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General NPI Number Information
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NPI Number | 1730047283
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Entity Type | Individual
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Provider Name | MICAH RITT
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Gender | Male
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Dates
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Enumeration Date | 01/13/2026
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Last Update Date | 02/18/2026
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Provider Practice Location Address
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Address Line | 4700 MEMORIAL DR STE 210
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City | BELLEVILLE
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State | IL
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Zip | 62226-5373
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Country | US
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Telephone | 618-767-7700
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 959203
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City | SAINT LOUIS
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State | MO
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Zip | 63195-9203
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Country | US
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Telephone | 618-767-7700
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Fax | 618-257-6794
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 085011833
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License Number State | IL
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