Provider Demographics
NPI:1134352677
Name:CARING DERMATOLOGY CENTER PC
Entity type:Organization
Organization Name:CARING DERMATOLOGY CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAVINDRAKUMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:GANGADHARIAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:563-355-0015
Mailing Address - Street 1:4624 PROGRESS DR
Mailing Address - Street 2:SUITE D
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52807-3490
Mailing Address - Country:US
Mailing Address - Phone:563-355-0015
Mailing Address - Fax:
Practice Address - Street 1:4624 PROGRESS DR
Practice Address - Street 2:SUITE D
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52807-3490
Practice Address - Country:US
Practice Address - Phone:563-355-0015
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-01
Last Update Date:2009-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty