Provider Demographics
NPI:1518655695
Name:DOAD, SUZANNE (RD, LDN)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:DOAD
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10531 SWEETHAVEN LN
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:NC
Mailing Address - Zip Code:28075-9701
Mailing Address - Country:US
Mailing Address - Phone:980-297-3953
Mailing Address - Fax:
Practice Address - Street 1:8100 OLD MALLARD CREEK RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-2238
Practice Address - Country:US
Practice Address - Phone:704-380-4655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-27
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL005548133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered