Phulsuksombati, Michele

Phulsuksombati, Michele is an sole proprietor health care provider with primary practice located at 8200 Blue Heron Dr 2D, Frederick MD 21701-9358. She recently has only one registered license in Dietary & Nutritional Service Providers / Dietitian, Registered, which is considered as her primary health care specialty. Phulsuksombati, Michele can be contacted via phone (301) 788-5392.

Contact Information

Primary practice address
8200 Blue Heron Dr 2D Frederick MD 21701-9358
Phone: (301) 788-5392
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dietary & Nutritional Service Providers / Dietitian, Registered 133V00000X DX3822 Maryland

Profile Details

NPI number 1386014819
LBN Legal business name Phulsuksombati, Michele
Credentials MS, MED,RD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 26th, 2015
Last updated Sep 6th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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