MEDICARE: MEDSTAR HEALTH WEIGHT MANAGEMENT, LLC

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	133VN1201X	Obesity and Weight Management Nutrition Registered Dietitian

General Provider Information

NPI Number	:	1952172470
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDSTAR HEALTH WEIGHT MANAGEMENT, LLC

Provider Business Mailing Address
First Line	:	1099 WINTERSON RD STE 300
Second Line	:
City	:	LINTHICUM HEIGHTS
State	:	MD
Zip	:	21090-2279
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1099 WINTERSON RD STE 300
Second Line	:
City	:	LINTHICUM HEIGHTS
State	:	MD
Zip	:	21090-2279
Country	:	US
Telephone Number	:	800-905-3261
Fax Number	:

Authorized Official
Title or Position	:	VP REVENUE CYCLE OPERATIONS
Name	:	RONDA RICHERT
Credential	:
Telephone Number	:	800-905-3261

Provider Enumeration Date	:	01/12/2024
Last Update Date	:	09/19/2025

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