Individual
AMANDA PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
25 COURTENAY DRIVE, SUITE 7100A MSC 290, MEDICAL UNIVERSITY OF SOUTH CAROLINA, CHARLESTON, SC 29425
(843) 876-4867
(610) 568-3139
Mailing address
25 COURTENAY DRIVE, SUITE 7100A MSC 290, MEDICAL UNIVERSITY OF SOUTH CAROLINA, CHARLESTON, SC 29425
(843) 876-4867
(484) 334-7026
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1219
SC
133V00000X
Registered Dietitian
—
—
Other
Enumeration date
05/29/2012
Last updated
01/14/2015
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