Individual
DOROTHY S SHAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD,LD/N
Contact information
Practice address
3631 PETERS CREEK RD NW, ROANOKE, VA 24019-2809
(540) 561-3341
(540) 563-3630
Mailing address
409 WASHINGTON AVE SW, ROANOKE, VA 24016-4217
(540) 815-6937
(540) 563-3630
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
L003065
NC
133V00000X
Registered Dietitian
Primary
L003065
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
677
STATE
WV
01
—
926124
DIETITIAN REGISTRATION - NATIONAL
—
01
—
KY2038
STATE
KY
01
—
L003065
STATE
NC
01
—
LD6018
STATE
OH
01
—
LDN0000001893
STATE
TN
Enumeration date
07/28/2008
Last updated
07/28/2008
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