Organization
NUTRGEN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. EVA EL-KHATIB CNS (PROGRAM DIRECTOR)
(301) 703-9923
Entity
Organization
Contact information
Practice address
13110 GLEN RD, NORTH POTOMAC, MD 20878-8852
(301) 703-9923
Mailing address
13110 GLEN RD, NORTH POTOMAC, MD 20878-8852
(301) 703-9923
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
DX4369
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DX4369
MARYLAND BOARD OF DIETETIC PRACTICE- FOR EVA EL-KHATIB
MD
Enumeration date
03/28/2018
Last updated
06/11/2019
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