Basic Information
| Provider Information | |||||||||
| NPI: | 1912938721 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RITTER | ||||||||
| FirstName: | STEPHEN | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 201 PENNSYLVANIA PARKWAY | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | INDIANAPOLIS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 462802301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3178171200 | ||||||||
| FaxNumber: | 3172081551 | ||||||||
| Practice Location | |||||||||
| Address1: | 201 PENNSYLVANIA PARKWAY | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | INDIANAPOLIS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 462802301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3178171200 | ||||||||
| FaxNumber: | 3172081551 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/06/2006 | ||||||||
| LastUpdateDate: | 07/16/2008 | ||||||||
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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 | 207X00000X | 35086465 | OH | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207X00000X | 01062442A | IN | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 200887310 | 05 | IN | MEDICAID | 2606899 | 05 | OH | MEDICAID |