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NPI Code Detail

MEDICARE: MEDSTAR HEALTH WEIGHT MANAGEMENT, LLC

MEDICARE: MEDSTAR HEALTH WEIGHT MANAGEMENT, LLC
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
1133VN1201XObesity and Weight Management Nutrition Registered Dietitian

General Provider Information

NPI Number : 1194596619
Entity Type Code : Organization
Provider Name (Legal Business Name) : MEDSTAR HEALTH WEIGHT MANAGEMENT, LLC
Provider Business Mailing Address
First Line : 1099 WINTERSON RD STE 300
Second Line :
City : LINTHICUM HEIGHTS
State : MD
Zip : 21090-2279
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6700 RACE TRACK RD
Second Line :
City : BOWIE
State : MD
Zip : 20715-3009
Country : US
Telephone Number : 301-383-2581
Fax Number :
Authorized Official
Title or Position : VP REVENUE CYCLE OPERATIONS
Name : RONDA RICHERT
Credential :
Telephone Number : 800-905-3261
Provider Enumeration Date : 01/12/2024
Last Update Date : 09/19/2025

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