Provider Demographics
NPI:1467703637
Name:WE CARE TWO PEDIATRICS, LLC
Entity Type:Organization
Organization Name:WE CARE TWO PEDIATRICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AKARI
Authorized Official - Middle Name:
Authorized Official - Last Name:TICHAVAKUNDA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:216-382-0555
Mailing Address - Street 1:PO BOX 22958
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44122-0958
Mailing Address - Country:US
Mailing Address - Phone:216-595-9600
Mailing Address - Fax:216-595-9601
Practice Address - Street 1:14100 CEDAR RD
Practice Address - Street 2:SUITE 270
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44121-3212
Practice Address - Country:US
Practice Address - Phone:216-382-0555
Practice Address - Fax:216-382-0726
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-27
Last Update Date:2012-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0929740Medicaid
OH0929740Medicaid