Provider Demographics
NPI:1336287838
Name:FEIRMAN, MINDY BLOCK (RN LD LN)
Entity Type:Individual
Prefix:
First Name:MINDY
Middle Name:BLOCK
Last Name:FEIRMAN
Suffix:
Gender:F
Credentials:RN LD LN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 HALESWORTH DR
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854
Mailing Address - Country:US
Mailing Address - Phone:301-251-3737
Mailing Address - Fax:301-251-7050
Practice Address - Street 1:2440 M ST NW
Practice Address - Street 2:SUITE 810
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037
Practice Address - Country:US
Practice Address - Phone:202-296-0777
Practice Address - Fax:301-251-7050
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCNU80133N00000X
DCD1106133V00000X
MDB00234133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered133N00000XDietary & Nutritional Service ProvidersNutritionist
Not Answered133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
212075OtherMAMSI MDIPA OPTIMUM CHOIC
000938413001OtherUNITED HEALTH CARE
000938413001OtherUNITED HEALTH CARE