MEDICARE: CARE DIABETES AND ENDOCRINOLOGY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	0101236869	VA

General Provider Information

NPI Number	:	1952317166
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARE DIABETES AND ENDOCRINOLOGY

Provider Business Mailing Address
First Line	:	89 SHERWOOD DR
Second Line	:
City	:	COLONIAL HEIGHTS
State	:	VA
Zip	:	23834-1447
Country	:	US
Telephone Number	:	804-526-3010
Fax Number	:	804-526-2293

Provider Business Practice Location Address
First Line	:	89 SHERWOOD DR
Second Line	:
City	:	COLONIAL HEIGHTS
State	:	VA
Zip	:	23834-1447
Country	:	US
Telephone Number	:	804-526-3010
Fax Number	:	804-526-2293

Authorized Official
Title or Position	:	DIRECTOR
Name	:	REKHA NUGARAM
Credential	:	M.D
Telephone Number	:	804-415-1273

Provider Enumeration Date	:	07/31/2006
Last Update Date	:	07/21/2022

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