Basic Information
| Provider Information | |||||||||
| NPI: | 1851370019 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RITTMEYER | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
| MiddleName: | H. | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 4750 WATERS AVE STE 307 | ||||||||
| Address2: | |||||||||
| City: | SAVANNAH | ||||||||
| State: | GA | ||||||||
| PostalCode: | 314046268 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9123507914 | ||||||||
| FaxNumber: | 9123507973 | ||||||||
| Practice Location | |||||||||
| Address1: | 4750 WATERS AVE STE 307 | ||||||||
| Address2: | |||||||||
| City: | SAVANNAH | ||||||||
| State: | GA | ||||||||
| PostalCode: | 314046268 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9123507914 | ||||||||
| FaxNumber: | 9123507973 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/15/2006 | ||||||||
| LastUpdateDate: | 01/18/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2080P0206X | 042407 | GA | Y | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Gastroenterology |
ID Information
| ID | Type | State | Issuer | Description | 37BBFSX | 01 | GA | MCARE ID FOR OLD PRACTICE | OTHER | G60175 | 05 | SC | MEDICAID | P00610135 | 01 | GA | RR MEDICARE | OTHER | 582162071-011 | 01 | GA | TRICARE AFFILIATION ID | OTHER | 000704987G | 05 | GA | MEDICAID | 345562 | 01 | GA | WELLCARE | OTHER | GPA748 | 01 | SC | MCAID GROUP ID | OTHER | 000704987E | 01 | GA | MCAID ID FOR OLD PRACTICE | OTHER |