MEDICARE: TAMRA DANIELLE ALMEIDA REGISTERED DIETITIAN

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	1078	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	NONE	OTHER		NONE

General Provider Information

NPI Number	:	1386273498
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMRA DANIELLE ALMEIDA REGISTERED DIETITIAN

Provider Business Mailing Address
First Line	:	4730 BUCKS BLUFF DR
Second Line	:
City	:	NORTH MYRTLE BEACH
State	:	SC
Zip	:	29582-6288
Country	:	US
Telephone Number	:	785-850-0844
Fax Number	:

Provider Business Practice Location Address
First Line	:	4730 BUCKS BLUFF DR
Second Line	:
City	:	NORTH MYRTLE BEACH
State	:	SC
Zip	:	29582-6288
Country	:	US
Telephone Number	:	785-850-0844
Fax Number	:

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

Provider Enumeration Date	:	04/02/2020
Last Update Date	:	04/02/2020

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