Provider Demographics
NPI:1528740909
Name:VOTAPKA, AMELIA J (RD)
Entity type:Individual
Prefix:MRS
First Name:AMELIA
Middle Name:J
Last Name:VOTAPKA
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:MIA
Other - Middle Name:
Other - Last Name:VOTAPKA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1303 BATTALION DR
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29412-9616
Mailing Address - Country:US
Mailing Address - Phone:843-534-3500
Mailing Address - Fax:
Practice Address - Street 1:1303 BATTALION DR
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29412-9616
Practice Address - Country:US
Practice Address - Phone:843-534-3500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-03
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLRD.1159.RD133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered