Provider Demographics
NPI:1770546517
Name:NANDA, VANDANA SOOD (MD)
Entity type:Individual
Prefix:
First Name:VANDANA
Middle Name:SOOD
Last Name:NANDA
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 PETER JEFFERSON PKWY STE 310
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-8836
Mailing Address - Country:US
Mailing Address - Phone:434-977-0027
Mailing Address - Fax:434-923-3376
Practice Address - Street 1:600 PETER JEFFERSON PKWY STE 310
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-8836
Practice Address - Country:US
Practice Address - Phone:434-977-0027
Practice Address - Fax:434-923-3376
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-11
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101238526207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAF42595Medicare UPIN
VA00W986A01Medicare ID - Type Unspecified