Provider Demographics
NPI:1851550313
Name:PEDERSEN, MARGARET FRANCES (RD, LD)
Entity Type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:FRANCES
Last Name:PEDERSEN
Suffix:
Gender:F
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 1:2165 N DECATUR RD
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-5307
Mailing Address - Country:US
Mailing Address - Phone:404-778-8607
Mailing Address - Fax:
Practice Address - Street 1:2165 N DECATUR RD
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-5307
Practice Address - Country:US
Practice Address - Phone:404-778-8607
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-09
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALD000105133VN1006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic