MEDICARE: MELISSA MAHEU MS, RD, LDN

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
2	133V00000X	Registered Dietitian	LDN00559	RI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	413226	OTHER	RI	BCBS-BLUECHIP
2	31814-3	OTHER	RI	BLUE CROSS BLUE SHIELD
3	31808	OTHER	RI	NEIGHBORHOOD HEALTH PLAN
4	002683999	OTHER	RI	UNITED HEALTH

General Provider Information

NPI Number	:	1013065366
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA MAHEU MS, RD, LDN

Provider Business Mailing Address
First Line	:	493 BROADWAY
Second Line	:
City	:	NEWPORT
State	:	RI
Zip	:	02840-1759
Country	:	US
Telephone Number	:	401-486-7089
Fax Number	:

Provider Business Practice Location Address
First Line	:	195 BROADWAY
Second Line	:
City	:	NEWPORT
State	:	RI
Zip	:	02840-2610
Country	:	US
Telephone Number	:	401-486-7089
Fax Number	:

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

Provider Enumeration Date	:	01/05/2007
Last Update Date	:	12/27/2024

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