Provider Demographics
NPI:1932243599
Name:RIPPLE, MARY GELETTA (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:GELETTA
Last Name:RIPPLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1200 BEACH PROMENADE
Mailing Address - Street 2:
Mailing Address - City:ORCHARD BEACH
Mailing Address - State:MD
Mailing Address - Zip Code:21226-2102
Mailing Address - Country:US
Mailing Address - Phone:443-375-0600
Mailing Address - Fax:
Practice Address - Street 1:900 W BALTIMORE ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21223-2595
Practice Address - Country:US
Practice Address - Phone:410-333-3265
Practice Address - Fax:410-333-3063
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2012-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0055316207ZF0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZF0201XAllopathic & Osteopathic PhysiciansPathologyForensic Pathology