Provider Demographics
NPI:1568134575
Name:RITCH, JULIA MARIA
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:MARIA
Last Name:RITCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 PONCE DE LEON PL UNIT 538
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-3282
Mailing Address - Country:US
Mailing Address - Phone:443-944-7424
Mailing Address - Fax:
Practice Address - Street 1:1462 CLIFTON RD NE STE 280
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-1063
Practice Address - Country:US
Practice Address - Phone:443-944-7424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-29
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPA200001659363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant