Provider Demographics
NPI:1245055078
Name:MEGHA VISHWANATHAN, FNU (PHD, RDN, LDN)
Entity type:Individual
Prefix:
First Name:FNU
Middle Name:
Last Name:MEGHA VISHWANATHAN
Suffix:
Gender:F
Credentials:PHD, RDN, LDN
Other - Prefix:DR
Other - First Name:MEGHA
Other - Middle Name:
Other - Last Name:VISHWANATHAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:400 STAR MAGNOLIA DR
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-7806
Mailing Address - Country:US
Mailing Address - Phone:404-645-2266
Mailing Address - Fax:
Practice Address - Street 1:400 STAR MAGNOLIA DR
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27560-7806
Practice Address - Country:US
Practice Address - Phone:404-645-2266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-18
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL007213133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered