Healthcare Provider Details

I. General information

NPI: 1952332140
Provider Name (Legal Business Name): DAVID WAYNE CHANDLER PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5109 LEESBURG PIKE # 687
FALLS CHURCH VA
22041-3215
US

IV. Provider business mailing address

6372 BRIGHT PLUME
COLUMBIA MD
21044-3746
US

V. Phone/Fax

Practice location:
  • Phone: 703-681-4239
  • Fax:
Mailing address:
  • Phone: 703-681-4239
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberAY980
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: