Individual
MARK E RITTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2022 KELLE DR, CHESTERTON, IN 46304-8708
(219) 395-2200
(219) 983-1837
Mailing address
2022 KELLE DR, CHESTERTON, IN 46304-8708
(219) 364-3616
(219) 364-3610
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01037402A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000203749
PROVIDER BCBS NUMBER
IN
01
—
110219045
RAILROAD PROVIDER NUMBER
IN
Enumeration date
12/19/2006
Last updated
09/14/2020
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