Individual
MR. SAMUEL HOUGHTON MUDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, RD, LDN
Contact information
Practice address
1493 CAMBRIDGE ST, CAMBRIDGE, MA 02139-1099
(617) 665-1000
Mailing address
29 BRAINERD RD APT 105, BOSTON, MA 02134-4526
(603) 703-1934
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
5233
MA
Other
Enumeration date
11/30/2021
Last updated
11/30/2021
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