Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Anzor Modzgvreschvili, RD

Individual provider Gerontological Nutrition Registered Dietitian · NPI 1245866862

Anzor Modzgvreschvili, RD is a Gerontological Nutrition Registered Dietitian in Detroit, Michigan. Works from 2 locations. Licensed in Maryland.

Licensed in
MD
In the registry since
2020
Specialties on file
2
What do these letters mean?
RD — Registered Dietitian
A credentialed nutrition professional.

See every abbreviation used in this directory →

Practice location Address checks out

15750 Joy Rd
Detroit, MI 48228-2196
Phone: (313) 273-6850
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 8600 Old Georgetown Rd, Bethesda, MD 20814-1422 — (301) 896-2578

Specialties & licences

Gerontological Nutrition Registered Dietitian (primary) Taxonomy 133VN1101X · Licence C05672 (MD)
Gerontological Nutrition Registered Dietitian Taxonomy 133VN1101X

Record details

NPI number1245866862
Entity typeIndividual (Type 1)
GenderMale
Credentials RD
Sole proprietorNo
NPI enumeratedMarch 15, 2020
Last updated in NPPESSeptember 20, 2022
Certification dateSeptember 20, 2022