Individual
MICHELLE LILA BLITSTEIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. R.D.
Contact information
Practice address
4812 CARMEL PARK DR, CHARLOTTE, NC 28226-5131
(704) 491-5616
(704) 442-6360
Mailing address
4812 CARMEL PARK DR, CHARLOTTE, NC 28226-5131
(704) 491-5616
(704) 892-2212
Taxonomy
Speciality
Code
Description
License number
State
133VN1006X
Metabolic Nutrition Registered Dietitian
Primary
L001566
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
142T8
BCBS NORTH CAROLINA
NC
01
—
2993129
MRCE NC PTAN
NC
Enumeration date
12/09/2007
Last updated
02/24/2010
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