MEDICARE: ROBERT MARK RITCHEA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	033688	GA
2	207R00000X	Internal Medicine Physician	00019887	AL

General Provider Information

NPI Number	:	1013998640
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT MARK RITCHEA M.D.

Provider Business Mailing Address
First Line	:	5009 RIVER CHASE DR
Second Line	:	BLDG 200
City	:	PHENIX CITY
State	:	AL
Zip	:	36867-7425
Country	:	US
Telephone Number	:	334-448-8007
Fax Number	:	334-448-1669

Provider Business Practice Location Address
First Line	:	5009 RIVER CHASE DR
Second Line	:	BLDG. 200
City	:	PHENIX CITY
State	:	AL
Zip	:	36867-7425
Country	:	US
Telephone Number	:	334-448-8007
Fax Number	:	334-448-1669

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/10/2005
Last Update Date	:	03/04/2008

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