Provider Demographics
NPI:1053066175
Name:NUTRITION AND METABOLIC CLINIC LLC
Entity type:Organization
Organization Name:NUTRITION AND METABOLIC CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:NEGIN
Authorized Official - Middle Name:
Authorized Official - Last Name:NAVAEI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, RDN
Authorized Official - Phone:404-981-7074
Mailing Address - Street 1:2205 HEATHERMOOR HILL DR
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-6502
Mailing Address - Country:US
Mailing Address - Phone:770-426-2742
Mailing Address - Fax:
Practice Address - Street 1:2205 HEATHERMOOR HILL DR
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-6502
Practice Address - Country:US
Practice Address - Phone:404-981-7074
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-16
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty