Provider Demographics
NPI:1205553443
Name:GIANG, MICHELLE (MS, RD, LD)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:GIANG
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4500 BRADSTONE TRCE NW
Mailing Address - Street 2:
Mailing Address - City:LILBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30047-8018
Mailing Address - Country:US
Mailing Address - Phone:404-271-8195
Mailing Address - Fax:
Practice Address - Street 1:BRIAN D. ALLGOOD ARMY COMMUNITY HOSPITAL (BDAACH)
Practice Address - Street 2:UNIT #15245 BLDG 3031
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96271
Practice Address - Country:US
Practice Address - Phone:315-737-2019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-27
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALD004607133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered