Provider Demographics
NPI:1891774758
Name:RITCHEY, MICHAEL JOSEPH (DPM)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JOSEPH
Last Name:RITCHEY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2615 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BEXLEY
Mailing Address - State:OH
Mailing Address - Zip Code:43209-2445
Mailing Address - Country:US
Mailing Address - Phone:614-231-7162
Mailing Address - Fax:614-231-3081
Practice Address - Street 1:2615 E MAIN ST
Practice Address - Street 2:
Practice Address - City:BEXLEY
Practice Address - State:OH
Practice Address - Zip Code:43209-2445
Practice Address - Country:US
Practice Address - Phone:614-231-7162
Practice Address - Fax:614-231-3081
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36-00-1768-R213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0330476Medicaid
OH0426451Medicare ID - Type UnspecifiedCOLUMBUS OHIO MEDICARE
OH0330476Medicaid
OH0426453Medicare ID - Type UnspecifiedLANCASTER OHIO MEDICARE