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NPI Code Detail

MEDICARE: TAMARA MELTON RD, LD

MEDICARE:   TAMARA  MELTON  RD, LD
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
1133V00000XRegistered DietitianLD003139GA

General Provider Information

NPI Number : 1326214446
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAMARA MELTON RD, LD
Provider Business Mailing Address
First Line : 2451 CUMBERLAND PKWY SE STE 3861
Second Line :
City : ATLANTA
State : GA
Zip : 30339-6136
Country : US
Telephone Number : 677-490-5991
Fax Number :
Provider Business Practice Location Address
First Line : 3225 CUMBERLAND BLVD SE STE 100
Second Line :
City : ATLANTA
State : GA
Zip : 30339-6408
Country : US
Telephone Number : 678-490-5991
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2008
Last Update Date : 12/13/2023

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Directions to “ TAMARA MELTON RD, LD” Practice Location

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