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

Samuel Mark Bullard

Individual provider Registered Dietitian · NPI 1649067422

Samuel Mark Bullard is a Registered Dietitian in Snellville, Georgia. Practices as a sole proprietor. Licensed in Georgia.

Licensed in
GA
In the registry since
2025
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Practice location Address checks out

3783 Galdway Dr
Snellville, GA 30039-5123
Phone: (678) 404-1396
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Registered Dietitian (primary) Taxonomy 133V00000X · Licence LD006062 (GA)

Record details

NPI number1649067422
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedApril 23, 2025
Last updated in NPPESApril 23, 2025
Certification dateApril 23, 2025
Mailing address3783 Galdway Dr, Snellville, GA 30039-5123

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