Provider Demographics
NPI:1922257146
Name:RITCHIE, SIMON ALEXANDER (MD)
Entity Type:Individual
Prefix:DR
First Name:SIMON
Middle Name:ALEXANDER
Last Name:RITCHIE
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 1:2093 PHILADELPHIA PIKE # 2696
Mailing Address - Street 2:
Mailing Address - City:CLAYMONT
Mailing Address - State:DE
Mailing Address - Zip Code:19703-2424
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:218-228-0904
Practice Address - Street 1:1060 W PERIMETER RD
Practice Address - Street 2:
Practice Address - City:JB ANDREWS
Practice Address - State:MD
Practice Address - Zip Code:20762-6602
Practice Address - Country:US
Practice Address - Phone:301-704-9743
Practice Address - Fax:218-228-0904
Is Sole Proprietor?:No
Enumeration Date:2008-09-11
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP8407171000000X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No171000000XOther Service ProvidersMilitary Health Care Provider