MEDICARE: V. PREM CHANDAR, M.D., P.A.

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	207RG0100X	Gastroenterology Physician	D16380	MD

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	100006612	OTHER	DC	MEDICARE RR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245380278
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	V. PREM CHANDAR, M.D., P.A.

Provider Business Mailing Address
First Line	:	6001 LANDOVER RD
Second Line	:	SUITE 3
City	:	CHEVERLY
State	:	MD
Zip	:	20785-1143
Country	:	US
Telephone Number	:	301-773-1111
Fax Number	:	301-773-7869

Provider Business Practice Location Address
First Line	:	6001 LANDOVER RD
Second Line	:	SUITE 3
City	:	CHEVERLY
State	:	MD
Zip	:	20785-1143
Country	:	US
Telephone Number	:	301-773-1111
Fax Number	:	301-773-7869

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. SASIKALA CHANDAR
Credential	:
Telephone Number	:	301-773-1111

Provider Enumeration Date	:	01/11/2007
Last Update Date	:	09/26/2012

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Directions to “V. PREM CHANDAR, M.D., P.A. ” Practice Location

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