| Mariam M Basma, RD | |
|
640 S State St, Dover, DE 19901-3530 | |
| (302) 744-6842 | |
| Not Available |
| Full Name | Mariam M Basma |
|---|---|
| Gender | Female |
| Speciality | Dietitian, Registered |
| Location | 640 S State St, Dover, Delaware |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073575239 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 133V00000X | Dietitian, Registered | DN-0000224 (Delaware) | Primary |
| Provider Name | Nourish, Inc. |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1558097824 PECOS PAC ID: 1557724937 Enrollment ID: O20230901000471 |
| Mailing Address | Practice Location Address |
|---|---|
| Mariam M Basma, RD 6 Maureen Way, Bear, DE 19701-6338 Ph: (302) 836-9476 | Mariam M Basma, RD 640 S State St, Dover, DE 19901-3530 Ph: (302) 744-6842 |
Lisa Garlick, Dietitian Medicare: Not Enrolled in Medicare Practice Location: 748 S New St, Suites C & D, Dover, DE 19904 Phone: 302-734-3227 Fax: 302-734-0391 | |
Dawn Santacroce, RDN LDN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 640 S State St, Dover, DE 19901 Phone: 302-744-6235 | |
Mrs. Rebecca Ann Montano, RD, LDN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 25 Maggies Way, Dover, DE 19901 Phone: 302-450-3217 | |
Kristin Elizabeth Blackway, RD, LDN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 640 S State St, Dover, DE 19901 Phone: 302-744-6597 | |
Lee Ann Kessler, RD Dietitian Medicare: Medicare Enrolled Practice Location: 103 Wolf Creek Blvd Ste 2, Dover, DE 19901 Phone: 302-744-6307 Fax: 302-730-3047 | |
Adriana Tavares Simoes, RD, LDN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 640 S State St, Dover, DE 19901 Phone: 302-744-6396 |