Carmen L Bates, LD

Individual provider Active NPI Registered Dietitian · Lawrenceville, GA

NPI 1669535209 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1669535209
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
LD001396 (GA)
Practice address
2570 Riverside Pkwy
Lawrenceville, GA 30046-0897
Phone
(770) 339-4260
NPI assigned
Dec 18, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
LD001396GAMDRegistered Dietitian

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X LD001396 GA Yes

Addresses

Primary practice location

2570 Riverside Pkwy
Lawrenceville, GA 30046-0897

Mailing address

PO Box 897
Lawrenceville, GA 30046-0897
Phone (678) 442-6880

Other providers in Lawrenceville, GA

All providers in Lawrenceville, GA · Registered Dietitian in Georgia

Sources for this page

Verify at the official NPI Registry.