MEDICARE: MICHELE R RITTER MD

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	207Q00000X	Family Medicine Physician	MR070661	MI

General Provider Information

NPI Number	:	1780616540
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELE R RITTER MD

Provider Business Mailing Address
First Line	:	PO BOX 510
Second Line	:
City	:	UNION LAKE
State	:	MI
Zip	:	48387-0510
Country	:	US
Telephone Number	:	248-932-2932
Fax Number	:	248-932-2953

Provider Business Practice Location Address
First Line	:	1396 SCOTT LAKE RD
Second Line	:
City	:	WATERFORD
State	:	MI
Zip	:	48328-1578
Country	:	US
Telephone Number	:	248-932-2932
Fax Number	:	248-932-2953

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

Provider Enumeration Date	:	07/06/2006
Last Update Date	:	09/22/2009

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