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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MARY ETTA JAMES GRESHAM, R.D.L.D.

Active Sole Proprietor

MARY ETTA JAMES GRESHAM, R.D.L.D. is a Renal Nutrition healthcare provider located in LITHONIA, Georgia. NPI 1316057862 is currently active in the NPPES registry. Verify at CMS.

Renal Nutrition · LITHONIA, GA

Registration Details

NPI Number
1316057862
Provider Type
Individual
Gender
Female
NPI Issued
Aug 30, 2006 (19.979155543976 yrs)
Last Updated
Jul 31, 2008
License
LD000377 (GA)
Sole Proprietor
Yes

Practice Information

Address
5330 CAYUGA CT
LITHONIA, GA, 300381106
Browse GA providers · Browse ZIP 30038
Phone
4045786525
Primary Specialty
Renal Nutrition
133VN1005X
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.