Healthcare Provider Details

I. General information

NPI: 1659890630
Provider Name (Legal Business Name): CHRISTOPHER NATHANIEL DARE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/12/2017
Last Update Date: 09/06/2026
Certification Date: 09/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46528 VALLEY CT APT 3011
LEXINGTON PARK MD
20653-1871
US

IV. Provider business mailing address

46528 VALLEY CT APT 3011
LEXINGTON PARK MD
20653-1871
US

V. Phone/Fax

Practice location:
  • Phone: 443-771-4769
  • Fax:
Mailing address:
  • Phone: 444-437-7147
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number10272974222
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: