Provider Demographics
NPI:1639814643
Name:GALLIER, JEREME' A (RD, LD)
Entity Type:Individual
Prefix:
First Name:JEREME'
Middle Name:A
Last Name:GALLIER
Suffix:
Gender:M
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1438 DECATUR ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21230-5213
Mailing Address - Country:US
Mailing Address - Phone:601-595-0985
Mailing Address - Fax:
Practice Address - Street 1:1020 HULL ST # 1
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21230-5356
Practice Address - Country:US
Practice Address - Phone:410-752-0300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-03
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALD006072133VN1501X
MDDX5606133VN1501X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1501XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Sports Dietetics