Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
ANZOR MODZGVRESCHVILI, RD
ActiveANZOR MODZGVRESCHVILI, RD is a Gerontological Nutrition healthcare provider located in DETROIT, Michigan. NPI 1245866862 is currently active in the NPPES registry. Verify at CMS.
Gerontological Nutrition · DETROIT, MI
Registration Details
- NPI Number
- 1245866862
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Mar 15, 2020 (6.4430425670693 yrs)
- Last Updated
- Sep 20, 2022
- License
-
C05672 (MD)
Practice Information
- Address
-
15750 JOY RDDETROIT, MI, 482282196Browse MI providers · Browse ZIP 48228
- Phone
- 3132736850
- Primary Specialty
-
Gerontological Nutrition
133VN1101X
- Additional Specialty
- Gerontological Nutrition
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.