Healthcare Provider Details

I. General information

NPI: 1619748357
Provider Name (Legal Business Name): MARIA MARGARET BRUMFIELD MS, RDN, LD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2024
Last Update Date: 01/11/2024
Certification Date: 01/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CHILDRENS PLZ
DAYTON OH
45404-1815
US

IV. Provider business mailing address

2781 PEBBLE STONE TRL
XENIA OH
45385-7580
US

V. Phone/Fax

Practice location:
  • Phone: 937-641-3260
  • Fax: 937-641-5909
Mailing address:
  • Phone: 330-635-6121
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number09078
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: