Individual
KEVIN SCOTT GRODNITZKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S., R.D., L.D.N.
Contact information
Practice address
1501 DIVISION ST, BALTIMORE, MD 21217-3121
(410) 728-4091
Mailing address
1 TROTTERS CT APT 102, PIKESVILLE, MD 21208-6722
(917) 576-4115
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
DX2677
MD
133V00000X
Registered Dietitian
Primary
DX2677
MD
Other
Enumeration date
03/23/2007
Last updated
11/27/2007
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