Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 94-131 | NM |
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 94-131 | NM |
NPI | 1164400602 |
---|---|
Provider Name | William L Ritchie IV |
First Address | Albuquerque, NM 87106-4917 |
Second Address | Albuquerque, NM 87106-4917 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/01/2006 |
Last Update Date | 01/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000J5349 | (05) | NM |
C21095 | (02) |