Provider Demographics
NPI:1710202759
Name:SMITH, MARGARET GILL (RD)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:GILL
Last Name:SMITH
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 FORT BOONE CT
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27527-3729
Mailing Address - Country:US
Mailing Address - Phone:912-414-6315
Mailing Address - Fax:
Practice Address - Street 1:486 NC-42
Practice Address - Street 2:100
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27511-2752
Practice Address - Country:US
Practice Address - Phone:919-990-1130
Practice Address - Fax:984-244-0506
Is Sole Proprietor?:No
Enumeration Date:2010-04-01
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL002816133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered