Provider Demographics
NPI:1538155270
Name:RITTENHOUSE, MARK CHARLES (MD)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:CHARLES
Last Name:RITTENHOUSE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:7940 FLOYD CURL
Mailing Address - Street 2:#840
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3905
Mailing Address - Country:US
Mailing Address - Phone:210-614-3349
Mailing Address - Fax:210-614-7550
Practice Address - Street 1:7940 FLOYD CURL
Practice Address - Street 2:#840
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3905
Practice Address - Country:US
Practice Address - Phone:210-614-3349
Practice Address - Fax:210-614-7550
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2013-07-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXE0593208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX089881903Medicaid