Provider Demographics
NPI:1285635649
Name:CHADIVE, VASANTHI (MD,)
Entity Type:Individual
Prefix:DR
First Name:VASANTHI
Middle Name:
Last Name:CHADIVE
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 1:6078 FRANCONIA RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22310-4400
Mailing Address - Country:US
Mailing Address - Phone:703-921-0256
Mailing Address - Fax:703-832-0704
Practice Address - Street 1:6078 FRANCONIA RD
Practice Address - Street 2:SUITE A
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22310-4400
Practice Address - Country:US
Practice Address - Phone:703-921-0256
Practice Address - Fax:703-832-0704
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101231789208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics