Provider Demographics
NPI:1578841532
Name:CENTER FOR ORTHOPAEDICS & SPORTS MEDICINE INC
Entity Type:Organization
Organization Name:CENTER FOR ORTHOPAEDICS & SPORTS MEDICINE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RAMESH
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANDRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-848-0800
Mailing Address - Street 1:8230 BOONE BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:TYSONS CORNER
Mailing Address - State:VA
Mailing Address - Zip Code:22182-2621
Mailing Address - Country:US
Mailing Address - Phone:703-848-0800
Mailing Address - Fax:703-848-0825
Practice Address - Street 1:8230 BOONE BLVD STE 200
Practice Address - Street 2:
Practice Address - City:TYSONS CORNER
Practice Address - State:VA
Practice Address - Zip Code:22182-2647
Practice Address - Country:US
Practice Address - Phone:703-848-0800
Practice Address - Fax:703-848-0825
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-25
Last Update Date:2012-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAG01729Medicare UPIN