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General NPI Number Information
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NPI Number | 1295956563
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Entity Type | Individual
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Provider Name | SANDEEP SANDHU M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/02/2007
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Last Update Date | 06/22/2021
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Provider Practice Location Address
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Address Line | 14139 POTOMAC MILLS RD
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City | WOODBRIDGE
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State | VA
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Zip | 22192-4644
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Country | US
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Telephone | 703-490-7672
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Fax |
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Provider Business Mailing Address
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Address Line | 3600 JOSEPH SIEWICK DR
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City | FAIRFAX
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State | VA
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Zip | 22033-1709
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Country | US
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Telephone | 719-999-2265
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MT187339
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 0101243247
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License Number State | VA
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