Individual
DR. COLIN MICHAEL RIDENOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2251 DUBOIS DR, WARSAW, IN 46580-3212
(574) 269-2777
(574) 269-9828
Mailing address
2251 DUBOIS DR, WARSAW, IN 46580-3212
(574) 269-2777
(574) 269-9828
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
01085874A
IN
390200000X
Student in an Organized Health Care Education/Training Program
11019222A
IN
Other
Enumeration date
05/22/2017
Last updated
11/09/2021
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