Provider Demographics
NPI:1053180455
Name:MCCARRON, SUSAN HIPPCHEN (RD, LDN)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:HIPPCHEN
Last Name:MCCARRON
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16102 DRAYTON FARM DR
Mailing Address - Street 2:
Mailing Address - City:SPENCERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20868-3106
Mailing Address - Country:US
Mailing Address - Phone:240-832-6220
Mailing Address - Fax:
Practice Address - Street 1:16102 DRAYTON FARM DR
Practice Address - Street 2:
Practice Address - City:SPENCERVILLE
Practice Address - State:MD
Practice Address - Zip Code:20868-3106
Practice Address - Country:US
Practice Address - Phone:240-832-6220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-27
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD01603133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered