Provider Demographics
NPI:1992948673
Name:HARTLE, CARA G (DO)
Entity type:Individual
Prefix:DR
First Name:CARA
Middle Name:G
Last Name:HARTLE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:CARA
Other - Middle Name:T
Other - Last Name:GOLISH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:5875 BREMO RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-1934
Mailing Address - Country:US
Mailing Address - Phone:804-897-2100
Mailing Address - Fax:
Practice Address - Street 1:5875 BREMO RD
Practice Address - Street 2:SUITE 201
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-1934
Practice Address - Country:US
Practice Address - Phone:804-897-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-10
Last Update Date:2015-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
VA0102203394207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program