NPI 1023518313 · live from the CMS NPI Registry
Mary Balog, RD
Dietitian, Registered in Ann Arbor, MI. National Provider Identifier 1023518313, active.
NPI record
| NPI | 1023518313 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dietitian, Registered 133V00000X |
| Practice location | 116 Allen Dr, Ann Arbor, MI 48103 |
| Practice phone | 734-341-0307 |
| Enumerated | February 14, 2018 |
| Last updated | February 14, 2018 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered primary | 133V00000X | 1087732 (MI) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.