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General NPI Number Information
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NPI Number | 1699170894
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Entity Type | Organization
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Legal Business Name | DHURVACARE ENTERPRISES, LLC
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Dates
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Enumeration Date | 10/30/2014
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Last Update Date | 10/30/2014
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Provider Practice Location Address
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Address Line | 2702 BACK ACRE CIRCLE SUITE 290C
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City | MOUNT AIRY
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State | MD
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Zip | 21711-7769
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Country | US
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Telephone | 301-703-5067
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Fax | 301-703-5067
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Provider Business Mailing Address
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Address Line | 2702 BACK ACRE CIRCLE SUITE 290C
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City | MOUNT AIRY
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State | MD
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Zip | 21711-7769
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Country | US
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Telephone | 301-703-5067
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Fax | 301-703-5067
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. JYOTHI RAO-MAHADEVIA
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Credential | M.D.
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Telephone | 301-703-5067
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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