Individual
MARY BARNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
853 N CHURCH ST, SUITE 720C, SPARTANBURG, SC 29303-3098
(864) 560-6419
(864) 560-7498
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
185
SC
133V00000X
Registered Dietitian
—
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00708609
RR MEDICARE
SC
01
—
Q347996066
MEDICARE PIN
SC
Enumeration date
02/25/2008
Last updated
11/06/2018
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