Provider Demographics
NPI:1972958197
Name:DARE2CARE PEDIATRICS LLC
Entity Type:Organization
Organization Name:DARE2CARE PEDIATRICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER-
Authorized Official - Prefix:DR
Authorized Official - First Name:MADHURI
Authorized Official - Middle Name:
Authorized Official - Last Name:VISWANADHAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-615-7000
Mailing Address - Street 1:1960 MARCIA OVERLOOK DR
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-1329
Mailing Address - Country:US
Mailing Address - Phone:770-615-7000
Mailing Address - Fax:770-884-4170
Practice Address - Street 1:11125 JONES BRIDGE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30022-7415
Practice Address - Country:US
Practice Address - Phone:770-615-7000
Practice Address - Fax:770-884-4170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-25
Last Update Date:2016-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty