Provider Demographics
NPI:1043219710
Name:CHANDA, SANDHYA (MD)
Entity Type:Individual
Prefix:DR
First Name:SANDHYA
Middle Name:
Last Name:CHANDA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 17334
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21297-1334
Mailing Address - Country:US
Mailing Address - Phone:703-443-6717
Mailing Address - Fax:703-443-8643
Practice Address - Street 1:19450 DEERFIELD AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-6820
Practice Address - Country:US
Practice Address - Phone:571-223-5723
Practice Address - Fax:571-209-1848
Is Sole Proprietor?:No
Enumeration Date:2005-07-15
Last Update Date:2016-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101232028207R00000X, 207R00000X
PAMD430517208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
G60560Medicare UPIN
VA00X665I01Medicare PIN
DC8532-0001OtherCAREFIRST BC/BS
P00606028OtherMEDICARE RAILROAD
VA00X665I01Medicare PIN
PA109779LN7Medicare PIN
PA1018740320001Medicaid
VA1043219710Medicaid