Provider Demographics
NPI:1497864656
Name:TARANT, SANDY IVES (MD)
Entity Type:Individual
Prefix:DR
First Name:SANDY
Middle Name:IVES
Last Name:TARANT
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2710 AYLESFORD DR
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113-6031
Mailing Address - Country:US
Mailing Address - Phone:804-647-3002
Mailing Address - Fax:804-378-1514
Practice Address - Street 1:7101 JAHNKE RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23225-4017
Practice Address - Country:US
Practice Address - Phone:804-323-8893
Practice Address - Fax:804-323-8950
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
VA1010487182080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine