MEDICARE: MEGHAN H MALKA RD

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	L004364	NC

General Provider Information

NPI Number	:	1467840702
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGHAN H MALKA RD

Provider Business Mailing Address
First Line	:	PO BOX 60447
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28260-0447
Country	:	US
Telephone Number	:	704-384-5043
Fax Number	:	704-384-8895

Provider Business Practice Location Address
First Line	:	125 QUEENS RD STE 330
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28204-3419
Country	:	US
Telephone Number	:	704-384-5043
Fax Number	:	704-384-8895

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

Provider Enumeration Date	:	01/08/2015
Last Update Date	:	03/30/2023

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Directions to “ MEGHAN H MALKA RD” Practice Location

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