MEDICARE: DR. DAVID RIDDER 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	208600000X	Surgery Physician	25544	NV
2	208600000X	Surgery Physician	74218	AZ
3	2086S0102X	Surgical Critical Care Physician	25544	NV
4	2086S0102X	Surgical Critical Care Physician	74218	AZ
5	2086S0127X	Trauma Surgery Physician	74218	AZ
6	2086S0127X	Trauma Surgery Physician	25544	NV

General Provider Information

NPI Number	:	1154778207
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID RIDDER M.D.

Provider Business Mailing Address
First Line	:	4700 LAS VEGAS BLVD N
Second Line	:
City	:	NELLIS AFB
State	:	NV
Zip	:	89191-6600
Country	:	US
Telephone Number	:	702-653-2273
Fax Number	:

Provider Business Practice Location Address
First Line	:	1851 MESQUITE AVE STE 210
Second Line	:
City	:	LAKE HAVASU CITY
State	:	AZ
Zip	:	86403-5681
Country	:	US
Telephone Number	:	928-854-7540
Fax Number	:	928-885-4240

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

Provider Enumeration Date	:	05/18/2016
Last Update Date	:	08/20/2024

Similar Medicare Providers

1497744577 — SCOTT JOSEPH COOLE D.O.
Practice Location Address:

1851 MESQUITE AVE STE 210
LAKE HAVASU CITY, AZ
86403-5681

Practice Phone: 928-854-7540
Practice Fax: 928-854-2505

1629048046 — WAYNE M CUMBRIA M.D.
Practice Location Address:

1851 MESQUITE AVE STE 216
LAKE HAVASU CITY, AZ
86403-5681

Practice Phone: 928-854-5358
Practice Fax: 928-854-5367

1386095743 — STEVEN MASSAD MD
Practice Location Address:

1851 MESQUITE AVE STE 202
LAKE HAVASU CITY, AZ
86403-5681

Practice Phone: 928-854-0094
Practice Fax: 928-680-8986

1205369162 — PARNIAN CHANGIZZADEH M.D
Practice Location Address:

1851 MESQUITE AVE STE 202
LAKE HAVASU CITY, AZ
86403-5681

Practice Phone: 928-854-0094
Practice Fax: 928-680-8986

1245739838 — SARAH BEATRICE SMITH
Practice Location Address:

1851 MESQUITE AVE STE 210
LAKE HAVASU CITY, AZ
86403-5681

Practice Phone: 928-854-7540
Practice Fax:

1841785219 — DR. JOSEPH CHINDO MD
Practice Location Address:

1851 MESQUITE AVE STE 216
LAKE HAVASU CITY, AZ
86403-5681

Practice Phone: 928-854-5358
Practice Fax:

Directions to “ DR. DAVID RIDDER M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.