Basic Information
Provider Information
NPI: 1770004608
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RITTER
FirstName: DANIEL
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3186 S MARYLAND PKWY
Address2:  
City: LAS VEGAS
State: NV
PostalCode: 891092317
CountryCode: US
TelephoneNumber: 7029615000
FaxNumber:  
Practice Location
Address1: 3186 S MARYLAND PKWY
Address2:  
City: LAS VEGAS
State: NV
PostalCode: 891092317
CountryCode: US
TelephoneNumber: 7029615000
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/30/2017
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/26/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000X4301112626MIY Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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