Provider Demographics
NPI:1033213566
Name:BITZER, REBECCA S (MS, RD)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:S
Last Name:BITZER
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6301 IVY LN STE 410
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-6357
Mailing Address - Country:US
Mailing Address - Phone:301-474-2499
Mailing Address - Fax:
Practice Address - Street 1:6301 IVY LN STE 410
Practice Address - Street 2:
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-6357
Practice Address - Country:US
Practice Address - Phone:301-474-2499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00045133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDG02262R01Medicare ID - Type Unspecified