MEDICARE: DR. C. ISABEL JANDER 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	2080A0000X	Pediatric Adolescent Medicine Physician	0101240285	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	D08720500	OTHER	NJ	CDS
2	0101240285	OTHER	VA	VA STATE LICENSE

General Provider Information

NPI Number	:	1720040298
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. C. ISABEL JANDER MD

Provider Business Mailing Address
First Line	:	8365A GREENSBORO DRIVE
Second Line	:
City	:	MCLEAN
State	:	VA
Zip	:	22102
Country	:	US
Telephone Number	:	703-356-4444
Fax Number	:	703-734-0129

Provider Business Practice Location Address
First Line	:	8365A GREENSBORO DRIVE
Second Line	:
City	:	MCLEAN
State	:	VA
Zip	:	22102
Country	:	US
Telephone Number	:	703-356-4444
Fax Number	:	703-734-0129

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

Provider Enumeration Date	:	04/03/2006
Last Update Date	:	03/07/2023

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