Provider Demographics
NPI:1548431646
Name:BARTELT, GLORIA OSTAFY (MPH, RD, LD)
Entity Type:Individual
Prefix:MRS
First Name:GLORIA
Middle Name:OSTAFY
Last Name:BARTELT
Suffix:
Gender:F
Credentials:MPH, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:178 N HIDDENBROOKE DR
Mailing Address - Street 2:
Mailing Address - City:ADVANCE
Mailing Address - State:NC
Mailing Address - Zip Code:27006-7299
Mailing Address - Country:US
Mailing Address - Phone:336-998-3181
Mailing Address - Fax:
Practice Address - Street 1:276 OLD MOCKSVILLE RD
Practice Address - Street 2:SUITE 400
Practice Address - City:STATESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28625-1949
Practice Address - Country:US
Practice Address - Phone:704-878-6592
Practice Address - Fax:704-878-6594
Is Sole Proprietor?:No
Enumeration Date:2008-03-17
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL003184133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered