Provider Demographics
NPI:1821055898
Name:CENTER FOR ORTHOPAEDICS AND SPORTS MEDICINE INC
Entity Type:Organization
Organization Name:CENTER FOR ORTHOPAEDICS AND 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:G
Authorized Official - Last Name:CHANDRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-848-0800
Mailing Address - Street 1:8230 BOONE BLVD
Mailing Address - Street 2:SUITE 200
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:
Practice Address - Street 1:2841 HARTLAND RD STE 401
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22043-3500
Practice Address - Country:US
Practice Address - Phone:703-848-0800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-26
Last Update Date:2012-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA36214207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAG01729Medicare ID - Type Unspecified