Provider Demographics
NPI:1518145960
Name:CHANDA, ARIJIT (MD)
Entity Type:Individual
Prefix:
First Name:ARIJIT
Middle Name:
Last Name:CHANDA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9530 COSNER DR STE 200
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22408-7760
Mailing Address - Country:US
Mailing Address - Phone:540-373-1331
Mailing Address - Fax:540-373-1124
Practice Address - Street 1:9530 COSNER DR STE 200
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22408-7760
Practice Address - Country:US
Practice Address - Phone:540-373-1331
Practice Address - Fax:540-373-1124
Is Sole Proprietor?:No
Enumeration Date:2008-02-07
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT00000000207R00000X
LA301848207RI0011X
VA0101262529207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS04635762Medicaid
LA2424742Medicaid
LA511989YH3UMedicare PIN