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NPI Code Detail

MEDICARE: MARK E RITTER M.D.

MEDICARE: MARK E RITTER 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
1207R00000XInternal Medicine Physician01037402AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1110219045OTHERINRAILROAD PROVIDER NUMBER
2000000203749OTHERINPROVIDER BCBS NUMBER

General Provider Information

NPI Number : 1609939511
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK E RITTER M.D.
Provider Business Mailing Address
First Line : 2022 KELLE DR
Second Line :
City : CHESTERTON
State : IN
Zip : 46304-8708
Country : US
Telephone Number : 219-364-3616
Fax Number : 219-364-3610
Provider Business Practice Location Address
First Line : 2022 KELLE DR
Second Line :
City : CHESTERTON
State : IN
Zip : 46304-8708
Country : US
Telephone Number : 219-395-2200
Fax Number : 219-983-1837
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2006
Last Update Date : 09/14/2020

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