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General NPI Number Information
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NPI Number | 1275340572
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Entity Type | Organization
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Legal Business Name | DRDS, PLLC
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Dates
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Enumeration Date | 12/11/2024
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Last Update Date | 12/11/2024
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Provider Practice Location Address
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Address Line | 3135 SPRINGBANK LN STE 140
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City | CHARLOTTE
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State | NC
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Zip | 28226-3363
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Country | US
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Telephone | 704-702-6555
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Fax | 704-702-6555
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Provider Business Mailing Address
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Address Line | 1235 EAST BLVD. ST E-266 E-266
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City | CHARLOTTE
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State | NC
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Zip | 28203
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Country | US
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Telephone | 813-482-8203
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MISS DENAE FREDERICK
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Credential |
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Telephone | 813-482-8203
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133VN1201X
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Taxonomy Name | Obesity and Weight Management Nutrition Registered Dietitian
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2083B0002X
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Taxonomy Name | Obesity Medicine (Preventive Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 202D00000X
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Taxonomy Name | Integrative Medicine Physician
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License Number |
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License Number State |
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