MEDICARE: CHRISTOPHER HALAGARDA 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	133VN1501X	Sports Dietetics Nutrition Registered Dietitian	912606
2	133V00000X	Registered Dietitian

General Provider Information

NPI Number	:	1780955534
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER HALAGARDA RD

Provider Business Mailing Address
First Line	:	100 BREWSTER BLVD
Second Line	:
City	:	CAMP LEJEUNE
State	:	NC
Zip	:	28547-2575
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	US MARINE CORPS FORCES COMMAND
Second Line	:	1775 FORRESTAL DRIVE
City	:	NORFOLK
State	:	VA
Zip	:	23551-0001
Country	:	US
Telephone Number	:	757-836-1685
Fax Number	:

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

Provider Enumeration Date	:	01/25/2012
Last Update Date	:	02/05/2025

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