Provider Demographics
NPI:1780954560
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:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RAMESH
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANDRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-828-0800
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
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:108 ELDEN STREET SUITE 15A
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20170
Practice Address - Country:US
Practice Address - Phone:703-828-0800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-10
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty