MEDICARE: MARIA BUXTON RDN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian	DX6022	MD

General Provider Information

NPI Number	:	1588368260
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA BUXTON RDN

Provider Business Mailing Address
First Line	:	7640 PARADISE BEACH RD
Second Line	:
City	:	PASADENA
State	:	MD
Zip	:	21122-3524
Country	:	US
Telephone Number	:	334-806-0730
Fax Number	:

Provider Business Practice Location Address
First Line	:	8388 COURT AVE STE 202
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21043-5203
Country	:	US
Telephone Number	:	443-355-7021
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/28/2023
Last Update Date	:	03/28/2023

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