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General NPI Number Information
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NPI Number | 1427380245
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Entity Type | Individual
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Provider Name | MELANIE DAWN BERTRAM R.D, L.D., C.S.R
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Gender | Female
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Dates
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Enumeration Date | 02/03/2010
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Last Update Date | 02/03/2010
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Provider Practice Location Address
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Address Line | 2945 GLENDALE RD
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City | MARIETTA
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State | OH
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Zip | 45750-8025
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Country | US
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Telephone | 740-236-0894
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Fax |
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Provider Business Mailing Address
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Address Line | 2945 GLENDALE RD
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City | MARIETTA
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State | OH
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Zip | 45750-8025
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Country | US
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Telephone | 740-236-0894
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133VN1005X
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Taxonomy Name | Renal Nutrition Registered Dietitian
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License Number | 4625
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 133VN1005X
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Taxonomy Name | Renal Nutrition Registered Dietitian
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License Number | 372
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License Number State | WV
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