| Doctor Name: | MS. SUSAN MARY RUNYAN |
| NPI Number: | 1760442297 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | REGISTERED DIETITIAN |
| License Number: | 110 |
| Business Practice Address: | 354th Medical Group 2630 Central Ave, Suite 1m07 Eielson Afb, AK - 99702 |
| Business Phone Number: | 9073776662 |
| Business Fax Number: | 9073771629 |
| Mailing Address: | 2594 Carrie Lynn Dr, NORTH POLE |
| State: | AK |
| Postal Code: | 997055639 |
| Phone Number: | 9074882968 |
| Fax Number: | |
| NPI Enumeration Date: | 03/27/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133V00000X |
| License Number: | 110 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AK |
| 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 |