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Individual

CHAD WESLEY MARK RITENOUR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1365B CLIFTON RD NE, SUITE B1400, ATLANTA, GA 30322-1013
(404) 778-4898
(404) 778-4006
Mailing address
1365B CLIFTON RD NE, SUITE B1400, ATLANTA, GA 30322-1013
(404) 778-4898
(404) 778-4006

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
043117
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000908333B
GA
Enumeration date
07/16/2006
Last updated
10/29/2012
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