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Mariana Gandolfo Bustamante, MS, RDN, CD

Dietitian, Registered in Madison, WI. Individual provider (NPI-1).

NPI number1003667072
StatusActive
Last updated in NPPESSep 22, 2025

Details

NPI
1003667072
Entity type
Individual (NPI-1)
Name
Mariana Gandolfo Bustamante
Credential
MS, RDN, CD
Sex
Female
Sole proprietor
No
Enumeration date
Mar 28, 2024
Certification date
Sep 22, 2025
Last updated
Sep 22, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
133V00000X Dietitian, Registered5427-29WIYes

Practice location

3209 Dryden Dr
Madison, WI 53704-3015

Phone 608-241-9020

Mailing address

7974 Uw Health Ct
Middleton, WI 53562-5531

Other practice locations

621 Science Dr
Madison, WI 53711-1074

Phone 608-265-8303

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