MEDICARE: ERIC WALTER CZANDER MD

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	2084N0400X	Neurology Physician	01011230338	VA

General Provider Information

NPI Number	:	1912997545
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIC WALTER CZANDER MD

Provider Business Mailing Address
First Line	:	1635 N GEORGE MASON DR
Second Line	:	STE 420
City	:	ARLINGTON
State	:	VA
Zip	:	22205-3601
Country	:	US
Telephone Number	:	703-536-4000
Fax Number	:	703-527-4339

Provider Business Practice Location Address
First Line	:	1635 N GEORGE MASON DR
Second Line	:	STE 420
City	:	ARLINGTON
State	:	VA
Zip	:	22205-3601
Country	:	US
Telephone Number	:	703-536-4000
Fax Number	:	703-527-4339

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/25/2005
Last Update Date	:	07/08/2007

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