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Individual

JOHN W RIDENOUR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
52 BERLIN RD, SUITE 5000, CHERRY HILL, NJ 08034-3574
(856) 795-1003
(856) 795-5994
Mailing address
52 BERLIN RD, SUITE 5000, CHERRY HILL, NJ 08034-3574
(856) 795-1003
(856) 795-5994

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
25MD00118100
NJ
213E00000X
Podiatrist
SC003575L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0056291
GHI
01
0109018000
INDENPENDENCE BLUE CROSS
PA
01
0513900000
KEYSTONE HEALTH PLAN
PA
01
0879760
CIGNA
NJ
01
10062
AMERIGROUP
NJ
01
1135993
HORIZON NJ HEALTH
NJ
01
16277
UNIVERSITY HEALTH PLAN
05
3182002
NJ
01
46711
AETNA
NJ
01
71268
OPERATING ENGINEERS
NJ
01
ME000007500
AMERICHOICE
NJ
01
P927643
OXFORD INSURANCE
NJ
Enumeration date
07/24/2006
Last updated
01/10/2012
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