Provider Demographics
NPI:1699170894
Name:DHURVACARE ENTERPRISES, LLC
Entity type:Organization
Organization Name:DHURVACARE ENTERPRISES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JYOTHI
Authorized Official - Middle Name:
Authorized Official - Last Name:RAO-MAHADEVIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-703-5067
Mailing Address - Street 1:2702 BACK ACRE CIRCLE
Mailing Address - Street 2:SUITE 290C
Mailing Address - City:MOUNT AIRY
Mailing Address - State:MD
Mailing Address - Zip Code:21711-7769
Mailing Address - Country:US
Mailing Address - Phone:301-703-5067
Mailing Address - Fax:301-703-5067
Practice Address - Street 1:2702 BACK ACRE CIRCLE
Practice Address - Street 2:SUITE 290C
Practice Address - City:MOUNT AIRY
Practice Address - State:MD
Practice Address - Zip Code:21711-7769
Practice Address - Country:US
Practice Address - Phone:301-703-5067
Practice Address - Fax:301-703-5067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-30
Last Update Date:2014-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty