Provider Demographics
NPI:1295711273
Name:RITTER, BRIGETTE BETH (MD)
Entity type:Individual
Prefix:DR
First Name:BRIGETTE
Middle Name:BETH
Last Name:RITTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:BRIGETTE
Other - Middle Name:BETH
Other - Last Name:RITTER MIEST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:8841 GARLAND LN N
Mailing Address - Street 2:
Mailing Address - City:MAPLE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55311-1418
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15800 95TH AVE N
Practice Address - Street 2:PARK NICOLLET MAPLE GROVE
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55369-4400
Practice Address - Country:US
Practice Address - Phone:952-993-3282
Practice Address - Fax:952-993-1425
Is Sole Proprietor?:No
Enumeration Date:2005-12-21
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN46613207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN834640200Medicaid
WI34578500Medicaid
MNI17584Medicare UPIN
MN834640200Medicaid
P002002285Medicare PIN