MEDICARE: DR. MANDEEP SANDHU 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	207R00000X	Internal Medicine Physician	0101221173	VA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00311835	OTHER		MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	236002	OTHER	VA	ANTHEM
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205836798
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MANDEEP SANDHU MD

Provider Business Mailing Address
First Line	:	19415 DEERFIELD AVE
Second Line	:	SUITE 115
City	:	LANSDOWNE
State	:	VA
Zip	:	20176-8452
Country	:	US
Telephone Number	:	703-729-2626
Fax Number	:	703-729-3141

Provider Business Practice Location Address
First Line	:	19415 DEERFIELD AVE
Second Line	:	SUITE 115
City	:	LANSDOWNE
State	:	VA
Zip	:	20176-8452
Country	:	US
Telephone Number	:	703-729-2626
Fax Number	:	703-729-3141

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

Provider Enumeration Date	:	07/26/2005
Last Update Date	:	02/27/2008

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Directions to “ DR. MANDEEP SANDHU MD” Practice Location

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