Healthcare Provider Details

I. General information

NPI: 1619156718
Provider Name (Legal Business Name): DARE MEDICAL & CARDIOVASCULAR ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2007
Last Update Date: 10/25/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

604 AMANDA STREET
MANTEO NC
27954
US

IV. Provider business mailing address

604 AMANDA STREET
MANTEO NC
27954
US

V. Phone/Fax

Practice location:
  • Phone: 252-473-3478
  • Fax: 252-473-3600
Mailing address:
  • Phone: 252-473-3478
  • Fax: 252-473-3600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. LINDSEY L. WHITE
Title or Position: PRESIDENT
Credential: M.D.
Phone: 252-338-9451