Provider Demographics
NPI:1346563194
Name:MARTIN, SARAH GABRIELLE (MS, RD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:GABRIELLE
Last Name:MARTIN
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 1:1283 MANDERLY DR
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48381-1316
Mailing Address - Country:US
Mailing Address - Phone:248-535-2434
Mailing Address - Fax:
Practice Address - Street 1:1283 MANDERLY DR
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:MI
Practice Address - Zip Code:48381-1316
Practice Address - Country:US
Practice Address - Phone:248-535-2434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-08
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered