Provider Demographics
NPI:1598715468
Name:WHEELER, MARTHA SCHWARTZ (MS, RD, CNSD, LDN)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:SCHWARTZ
Last Name:WHEELER
Suffix:
Gender:F
Credentials:MS, RD, CNSD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 ELM STREET
Mailing Address - Street 2:
Mailing Address - City:CARRBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27510
Mailing Address - Country:US
Mailing Address - Phone:919-286-0411
Mailing Address - Fax:919-416-5825
Practice Address - Street 1:111 ELM ST
Practice Address - Street 2:
Practice Address - City:CARRBORO
Practice Address - State:NC
Practice Address - Zip Code:27510-1719
Practice Address - Country:US
Practice Address - Phone:919-286-0411
Practice Address - Fax:919-416-5825
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL000735133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered