Individual
MADELINE ELAINE BLACKADAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD
Contact information
Practice address
41 PERIMETER CTR E STE 250, DUNWOODY, GA 30346-1902
(770) 871-3750
Mailing address
41 PERIMETER CTR E STE 250, DUNWOODY, GA 30346-1902
(770) 871-3750
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD006644
GA
Other
Enumeration date
11/17/2023
Last updated
11/17/2023
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