Provider Demographics
NPI:1184109969
Name:MCDONALD-HANGACH, SANDRA KAY (RDN)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:KAY
Last Name:MCDONALD-HANGACH
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5816 AMBOY ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48127
Mailing Address - Country:US
Mailing Address - Phone:313-318-3086
Mailing Address - Fax:248-545-0342
Practice Address - Street 1:23231 JOHN R RD
Practice Address - Street 2:
Practice Address - City:HAZEL PARK
Practice Address - State:MI
Practice Address - Zip Code:48030-1476
Practice Address - Country:US
Practice Address - Phone:248-545-0261
Practice Address - Fax:248-545-0342
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-27
Last Update Date:2018-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal