Provider Demographics
NPI:1497936025
Name:HARTMULLER, VIRGINIA W (RD, CDE)
Entity Type:Individual
Prefix:DR
First Name:VIRGINIA
Middle Name:W
Last Name:HARTMULLER
Suffix:
Gender:F
Credentials:RD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12005 GRAYTON RUN
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-7114
Mailing Address - Country:US
Mailing Address - Phone:410-988-4072
Mailing Address - Fax:443-546-3812
Practice Address - Street 1:12005 GRAYTON RUN
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-7114
Practice Address - Country:US
Practice Address - Phone:410-988-4072
Practice Address - Fax:443-546-3812
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-26
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00144133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered