Individual
MAUREEN SHACKELFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD CDE LD MA
Contact information
Practice address
2001 MEDICAL PKWY, ANNAPOLIS, MD 21401-3280
(443) 481-5368
Mailing address
1100 ELGIN CT, ANNAPOLIS, MD 21403-4358
(410) 267-0259
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
717104
MD
Other
Enumeration date
08/30/2006
Last updated
07/08/2007
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