Provider Demographics
NPI:1720040298
Name:JANDER, C. ISABEL (MD)
Entity Type:Individual
Prefix:DR
First Name:C. ISABEL
Middle Name:
Last Name:JANDER
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 1:8365A GREENSBORO DRIVE
Mailing Address - Street 2:
Mailing Address - City:MCLEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22102
Mailing Address - Country:US
Mailing Address - Phone:703-356-4444
Mailing Address - Fax:703-734-0129
Practice Address - Street 1:8365A GREENSBORO DRIVE
Practice Address - Street 2:
Practice Address - City:MCLEAN
Practice Address - State:VA
Practice Address - Zip Code:22102
Practice Address - Country:US
Practice Address - Phone:703-356-4444
Practice Address - Fax:703-734-0129
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012402852080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJD08720500OtherCDS
VA0101240285OtherVA STATE LICENSE
VA0101240285OtherVA STATE LICENSE