MEDICARE: ELIZABETH MARGARET DETWEILER MHSC, RDN, LDN

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	DN009656	PA

General Provider Information

NPI Number	:	1760310973
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH MARGARET DETWEILER MHSC, RDN, LDN

Provider Business Mailing Address
First Line	:	5047 FOXDALE DR
Second Line	:
City	:	WHITEHALL
State	:	PA
Zip	:	18052-2234
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5047 FOXDALE DR
Second Line	:
City	:	WHITEHALL
State	:	PA
Zip	:	18052-2234
Country	:	US
Telephone Number	:	610-730-2027
Fax Number	:

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

Provider Enumeration Date	:	05/11/2026
Last Update Date	:	05/11/2026

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