Provider Demographics
NPI:1164589925
Name:NEUMAIER, MARY CATHERINE (RD)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:CATHERINE
Last Name:NEUMAIER
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 SUTTEN DR
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48188-5237
Mailing Address - Country:US
Mailing Address - Phone:734-925-0509
Mailing Address - Fax:734-420-1074
Practice Address - Street 1:40020 FIVE MILE ROAD
Practice Address - Street 2:
Practice Address - City:NORTHVILLE
Practice Address - State:MI
Practice Address - Zip Code:48168
Practice Address - Country:US
Practice Address - Phone:734-925-0509
Practice Address - Fax:734-420-1074
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2009-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI868022133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered