Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 020347 | GA |
NPI | 1003857087 |
---|---|
Provider Name | Linda Ritter |
First Address | Athens, GA 30604-7297 |
Second Address | Athens, GA 30606-3712 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2006 |
Last Update Date | 07/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D30627 | (02) | GA |