Provider Demographics
NPI:1043853526
Name:SUSAN E. SHERWOOD RDN LLC
Entity type:Organization
Organization Name:SUSAN E. SHERWOOD RDN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:SHERWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RDN, LDN, CNSC
Authorized Official - Phone:614-203-1517
Mailing Address - Street 1:PO BOX 284
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43086-0284
Mailing Address - Country:US
Mailing Address - Phone:614-203-1517
Mailing Address - Fax:
Practice Address - Street 1:1555 BETHEL RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43220-2003
Practice Address - Country:US
Practice Address - Phone:614-203-1517
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-28
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
No133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Single Specialty