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NPI Code Detail

MEDICARE: RATNAWALI DUTTA RD

MEDICARE: RATNAWALI DUTTA 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
1133V00000XRegistered Dietitian

General Provider Information

NPI Number : 1881529055
Entity Type Code : Individual
Provider Name (Legal Business Name) : RATNAWALI DUTTA RD
Provider Business Mailing Address
First Line : 3064 KINGSFIELD DR
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23456-3481
Country : US
Telephone Number : 336-997-3268
Fax Number :
Provider Business Practice Location Address
First Line : 3064 KINGSFIELD DR
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23456-3481
Country : US
Telephone Number : 336-997-3268
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2026
Last Update Date : 06/17/2026

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Directions to “ RATNAWALI DUTTA RD” Practice Location

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