Provider Demographics
NPI:1306836275
Name:SOOD, KUMUD LATA (MS,RD,LD)
Entity Type:Individual
Prefix:MRS
First Name:KUMUD
Middle Name:LATA
Last Name:SOOD
Suffix:
Gender:F
Credentials:MS,RD,LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8720 BELL TOWER DR
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20879-1780
Mailing Address - Country:US
Mailing Address - Phone:301-869-9726
Mailing Address - Fax:
Practice Address - Street 1:50 W EDMONSTON DR
Practice Address - Street 2:SUITE 504
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-1228
Practice Address - Country:US
Practice Address - Phone:301-869-3754
Practice Address - Fax:301-869-3754
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-24
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDOO258133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered