Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | 70417 | GA |
N | 208000000X | Pediatrician | 017865 | LA |
N | 2080P0204X | Pediatric Emergency Doctor | 017865 | LA |
NPI | 1164454542 |
---|---|
Provider Name | Christopher P Ritchey |
First Address | Loganville, GA 30052-4245 |
Second Address | Lawrenceville, GA 30046-7694 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2006 |
Last Update Date | 15/07/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
003136101C | (05) | GA |
1367567 | (05) | LA |
F35640 | (02) | LA |