Healthcare Provider Details

I. General information

NPI: 1932167012
Provider Name (Legal Business Name): RAMESH G CHANDRA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2006
Last Update Date: 11/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8230 BOONE BLVD STE 200
TYSONS CORNER VA
22182-2647
US

IV. Provider business mailing address

8230 BOONE BLVD STE 200
TYSONS CORNER VA
22182-2647
US

V. Phone/Fax

Practice location:
  • Phone: 703-848-0800
  • Fax:
Mailing address:
  • Phone: 703-848-0800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number36214
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: