Provider Demographics
NPI:1477194058
Name:FLIEHMAN, HEATHER (RD/LDN)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:FLIEHMAN
Suffix:
Gender:F
Credentials:RD/LDN
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:
Other - Last Name:CHANDLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1589 SULPHUR SPRING RD STE 109
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21227-2542
Mailing Address - Country:US
Mailing Address - Phone:443-575-4880
Mailing Address - Fax:443-575-4891
Practice Address - Street 1:808 LANDMARK DR STE 122
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-4984
Practice Address - Country:US
Practice Address - Phone:410-760-3588
Practice Address - Fax:410-760-3604
Is Sole Proprietor?:No
Enumeration Date:2019-10-04
Last Update Date:2019-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDX2881133VN1005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal