Provider Demographics
NPI:1881736007
Name:BRANDOLINI, CHRIS WILLIAM (DC)
Entity type:Individual
Prefix:DR
First Name:CHRIS
Middle Name:WILLIAM
Last Name:BRANDOLINI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11302 VEIRS MILL RD
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:MD
Mailing Address - Zip Code:20902-2557
Mailing Address - Country:US
Mailing Address - Phone:301-962-7300
Mailing Address - Fax:301-962-8952
Practice Address - Street 1:11302 VEIRS MILL RD
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:MD
Practice Address - Zip Code:20902-2557
Practice Address - Country:US
Practice Address - Phone:301-962-7300
Practice Address - Fax:301-962-8952
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS01867111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0900XChiropractic ProvidersChiropractorInternist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD000C05F55Medicare ID - Type Unspecified
MDU70450Medicare UPIN