Provider Demographics
NPI:1609972736
Name:CALDWELL, ANN RAVOTTI (RD,LDN)
Entity Type:Individual
Prefix:MS
First Name:ANN
Middle Name:RAVOTTI
Last Name:CALDWELL
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 1:2002 MEDICAL PKWY STE 250
Mailing Address - Street 2:ANNAPOLIS
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-3279
Mailing Address - Country:US
Mailing Address - Phone:443-481-5364
Mailing Address - Fax:443-481-5375
Practice Address - Street 1:2002 MEDICAL PKWY STE 250
Practice Address - Street 2:ANNAPOLIS
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3279
Practice Address - Country:US
Practice Address - Phone:443-481-5364
Practice Address - Fax:443-481-5375
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00514133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered