Provider Demographics
NPI:1609837020
Name:RITTER, MICHELLE R (MD)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:R
Last Name:RITTER
Suffix:
Gender:F
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:PO BOX 6640
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71136-6640
Mailing Address - Country:US
Mailing Address - Phone:318-686-9986
Mailing Address - Fax:318-686-9505
Practice Address - Street 1:385 BERT KOUNS INDUSTRIAL LOOP
Practice Address - Street 2:SUITE 500
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71106-8158
Practice Address - Country:US
Practice Address - Phone:318-686-9986
Practice Address - Fax:318-686-9505
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-28
Last Update Date:2011-05-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA10060R207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1900H3213ZOtherBCBS OF LA
LA1900H3213ZOtherBCBS OF LA
LAG39725Medicare UPIN