1780648402 NPI number — RITCHIE H STEED D.P.M.

Table of content: RITCHIE H STEED D.P.M. (NPI 1780648402)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780648402 NPI number — RITCHIE H STEED D.P.M.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STEED
Provider First Name:
RITCHIE
Provider Middle Name:
H
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
D.P.M.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1780648402
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/09/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
630 COFFMAN ST
Provider Second Line Business Mailing Address:
STE. A
Provider Business Mailing Address City Name:
LONGMONT
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80501-8302
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-772-7008
Provider Business Mailing Address Fax Number:
866-358-1067

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
630 COFFMAN ST
Provider Second Line Business Practice Location Address:
STE. A
Provider Business Practice Location Address City Name:
LONGMONT
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80501-8302
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-772-7008
Provider Business Practice Location Address Fax Number:
866-358-1067
Provider Enumeration Date:
04/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 213ES0131X , with the licence number:  561 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2263531 . This is a "AETNA HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 841189022001 . This is a "TRICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 9742230003 . This is a "COMMERCIAL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 9742230002 . This is a "CIGNA PAL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0244690001 . This is a "PALMETTO" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: 84-1189022-04 . This is a "PACIFICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 480027697 . This is a "RR MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: ST637526 . This is a "CO BC/BS" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".




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