Provider Demographics
NPI:1912997545
Name:CZANDER, ERIC WALTER (MD)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:WALTER
Last Name:CZANDER
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:1635 N GEORGE MASON DR
Mailing Address - Street 2:STE 420
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22205-3601
Mailing Address - Country:US
Mailing Address - Phone:703-536-4000
Mailing Address - Fax:703-527-4339
Practice Address - Street 1:1635 N GEORGE MASON DR
Practice Address - Street 2:STE 420
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22205-3601
Practice Address - Country:US
Practice Address - Phone:703-536-4000
Practice Address - Fax:703-527-4339
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA010112303382084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H34430Medicare UPIN
006309N70Medicare ID - Type Unspecified