Provider Demographics
NPI:1487701736
Name:URYASZ, MARGARET (RD, LD)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:URYASZ
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:MARGIE
Other - Middle Name:
Other - Last Name:URYASZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RD LD
Mailing Address - Street 1:4005 SHADYBROOK CIR
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26508-8629
Mailing Address - Country:US
Mailing Address - Phone:806-787-2112
Mailing Address - Fax:
Practice Address - Street 1:198 MORGANTOWN ST
Practice Address - Street 2:
Practice Address - City:BRUCETON MILLS
Practice Address - State:WV
Practice Address - Zip Code:26525-5003
Practice Address - Country:US
Practice Address - Phone:806-787-2112
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT02609133V00000X
WV1066133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8DR379OtherBLUE CROSS BLUE SHIELD
TX005732502Medicaid
TX291918YNCJMedicare PIN