MEDICARE: MRS. MICHELLE COURTNEY PENDEL RD, LDN, CSSD

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	DN004925	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669955175
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MICHELLE COURTNEY PENDEL RD, LDN, CSSD

Provider Business Mailing Address
First Line	:	5750 BAUM BLVD # 306
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15206-3793
Country	:	US
Telephone Number	:	412-593-2048
Fax Number	:	844-311-7396

Provider Business Practice Location Address
First Line	:	3 ROBINSON PLZ # 205
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15205-1024
Country	:	US
Telephone Number	:	412-593-2048
Fax Number	:	844-311-7396

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

Provider Enumeration Date	:	09/11/2018
Last Update Date	:	11/27/2023

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