Mary D Gavin, MS, RD, LDN
Dietitian, Registered in Midland, NC. Individual provider (NPI-1).
NPI number1598965626
StatusActive
Last updated in NPPESOct 23, 2025
Details
- NPI
- 1598965626
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Mary D Gavin
- Credential
- MS, RD, LDN
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jul 18, 2007
- Certification date
- Oct 23, 2025
- Last updated
- Oct 23, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 133V00000X | Dietitian, Registered | L003052 | NC | Yes |
| 133N00000X | Nutritionist | – | – | |
| 133NN1002X | Nutritionist, Nutrition, Education | – | – | |
| 133VN1004X | Dietitian, Registered, Nutrition, Pediatric | – | – |
Practice location
10915 Sparkle Creek DrMidland, NC 28107-9542
Phone 843-509-5667
Mailing address
10915 Sparkle Creek DrMidland, NC 28107-9542
Phone 843-509-5667
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