Provider Demographics
NPI:1528038890
Name:RITTER, DREW D (MD)
Entity Type:Individual
Prefix:
First Name:DREW
Middle Name:D
Last Name:RITTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3676 PARKER BLVD
Mailing Address - Street 2:SUITE 390
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81008-2210
Mailing Address - Country:US
Mailing Address - Phone:719-595-7780
Mailing Address - Fax:719-595-7789
Practice Address - Street 1:3676 PARKER BLVD
Practice Address - Street 2:SUITE 390
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81008-2210
Practice Address - Country:US
Practice Address - Phone:719-595-7780
Practice Address - Fax:719-595-7789
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2017-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCO26424207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01264241Medicaid
C51367Medicare UPIN
CO5410910001Medicare NSC