Provider Demographics
NPI:1427041755
Name:RITTER, ANGELA D (MD)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:D
Last Name:RITTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2350 LIMESTONE PKWY
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30501-2013
Mailing Address - Country:US
Mailing Address - Phone:770-534-5154
Mailing Address - Fax:770-534-7793
Practice Address - Street 1:2350 LIMESTONE PKWY
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-2013
Practice Address - Country:US
Practice Address - Phone:770-534-5154
Practice Address - Fax:770-534-7793
Is Sole Proprietor?:No
Enumeration Date:2005-08-23
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA042712207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00751902CMedicaid
GA08BBWBXMedicare PIN
GA00751902CMedicaid