Provider Demographics
NPI:1780955534
Name:HALAGARDA, CHRISTOPHER (RD)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:HALAGARDA
Suffix:
Gender:M
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 BREWSTER BLVD
Mailing Address - Street 2:
Mailing Address - City:CAMP LEJEUNE
Mailing Address - State:NC
Mailing Address - Zip Code:28547-2575
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:US MARINE CORPS FORCES COMMAND
Practice Address - Street 2:1775 FORRESTAL DRIVE
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23551-0001
Practice Address - Country:US
Practice Address - Phone:757-836-1685
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-25
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
912606133VN1501X
133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133VN1501XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Sports Dietetics