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NPI Code Detail

MEDICARE: MARIANNE HINDER RD, CD, CDE

MEDICARE: MARIANNE HINDER RD, CD, CDE
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 Dietitian

General Provider Information

NPI Number : 1356590111
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIANNE HINDER RD, CD, CDE
Provider Business Mailing Address
First Line : 2405 NORTHWESTERN AVE
Second Line : RACINE COMMUNITY HEALTH CENTER
City : RACINE
State : WI
Zip : 53404-2534
Country : US
Telephone Number : 262-886-0474
Fax Number : 262-886-1672
Provider Business Practice Location Address
First Line : 2405 NORTHWESTERN AVE
Second Line : RACINE COMMUNITY HEALTH CENTER
City : RACINE
State : WI
Zip : 53404-2534
Country : US
Telephone Number : 262-886-0474
Fax Number : 262-886-1672
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/16/2008
Last Update Date : 09/16/2008

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