Provider Demographics
NPI:1053703074
Name:EPSTEIN, CARMEN (RD, CDE)
Entity type:Individual
Prefix:
First Name:CARMEN
Middle Name:
Last Name:EPSTEIN
Suffix:
Gender:F
Credentials:RD, CDE
Other - Prefix:
Other - First Name:CARMEN
Other - Middle Name:
Other - Last Name:BLUBAUGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1030 HARRINGTON ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:MOUNT CLEMENS
Mailing Address - State:MI
Mailing Address - Zip Code:48043-2967
Mailing Address - Country:US
Mailing Address - Phone:586-493-3396
Mailing Address - Fax:
Practice Address - Street 1:1030 HARRINGTON ST
Practice Address - Street 2:SUITE 202
Practice Address - City:MOUNT CLEMENS
Practice Address - State:MI
Practice Address - Zip Code:48043-2967
Practice Address - Country:US
Practice Address - Phone:586-493-3396
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-27
Last Update Date:2015-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered