Provider Demographics
NPI:1073670006
Name:CHAND, BANTI D (MD)
Entity Type:Individual
Prefix:DR
First Name:BANTI
Middle Name:D
Last Name:CHAND
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:2101 EAST JEFFERSON STREET PPQA MEDICARE COMPLIANCE UNI
Mailing Address - Street 2:KAISER PERMANENTE 6 WEST ATTN THERESA BROOKS
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4908
Mailing Address - Country:US
Mailing Address - Phone:301-816-2424
Mailing Address - Fax:301-816-6308
Practice Address - Street 1:19450 DEERFIELD AVENUE
Practice Address - Street 2:STE 300
Practice Address - City:LANSDOWNE
Practice Address - State:VA
Practice Address - Zip Code:20176-6820
Practice Address - Country:US
Practice Address - Phone:703-726-2100
Practice Address - Fax:703-726-4555
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2021-06-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101055726207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G88525Medicare UPIN
009275K32Medicare ID - Type Unspecified
005888M92Medicare ID - Type Unspecified