Individual
DR. RICHARD RETTIG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
1335 W TABOR RD, STE 206, PHILADELPHIA, PA 19141-3040
(215) 927-2837
(215) 927-2008
Mailing address
511 RIDGERUN LN, PHILADELPHIA, PA 19111-1357
(215) 285-1013
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
SC-002203-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0007644720004
—
PA
01
—
480001607
RAILROAD MEDICARE
PA
Enumeration date
05/23/2005
Last updated
03/13/2023
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