Doctor Name: | MS. MICHELLE ANNE MARDOCK |
NPI Number: | 1154401826 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | R.D. |
License Number: | DT06100 |
Business Practice Address: | U.s. Army Meddac, Heidelberg Cmr 442 Apo, AE - 09042-0130 |
Business Phone Number: | 06221172747 |
Business Fax Number: | |
Mailing Address: | Cmr 442 Box 472, APO |
State: | AE |
Postal Code: | 09042 |
Phone Number: | 017665818291 |
Fax Number: | |
NPI Enumeration Date: | 10/17/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | DT06100 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Dietary & Nutritional Service Providers |
Taxonomy Classification: | Dietitian, Registered |
Taxonomy Specialization: | |
Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |