Provider Demographics
NPI:1407857022
Name:CHANDLER, CANDACE IRENE (MD)
Entity Type:Individual
Prefix:DR
First Name:CANDACE
Middle Name:IRENE
Last Name:CHANDLER
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:2101 E JEFFERSON ST
Mailing Address - Street 2:KAISER PERMANENTE MEDICARE ENROLLMENT
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:
Practice Address - Street 1:1447 YORK RD STE 100
Practice Address - Street 2:KAISER PERMANENTE TOWSON MEDICAL OFFICE
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-6038
Practice Address - Country:US
Practice Address - Phone:410-339-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-04
Last Update Date:2011-12-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0029209207Q00000X
VA0101248787207QA0505X
DCMD039437207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine