Healthcare Provider Details

I. General information

NPI: 1588368260
Provider Name (Legal Business Name): MARIA BUXTON RDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2023
Last Update Date: 03/28/2023
Certification Date: 03/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8388 COURT AVE STE 202
ELLICOTT CITY MD
21043-5203
US

IV. Provider business mailing address

7640 PARADISE BEACH RD
PASADENA MD
21122-3524
US

V. Phone/Fax

Practice location:
  • Phone: 443-355-7021
  • Fax:
Mailing address:
  • Phone: 334-806-0730
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDX6022
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: