Provider Demographics
NPI:1932167012
Name:CHANDRA, RAMESH G (MD)
Entity Type:Individual
Prefix:
First Name:RAMESH
Middle Name:G
Last Name:CHANDRA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8230 BOONE BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:TYSONS CORNER
Mailing Address - State:VA
Mailing Address - Zip Code:22182-2647
Mailing Address - Country:US
Mailing Address - Phone:703-848-0800
Mailing Address - Fax:
Practice Address - Street 1:8230 BOONE BLVD STE 200
Practice Address - Street 2:
Practice Address - City:TYSONS CORNER
Practice Address - State:VA
Practice Address - Zip Code:22182-2647
Practice Address - Country:US
Practice Address - Phone:703-848-0800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2012-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA36214207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA541439176OtherTAX ID
VAC88119Medicare UPIN
VA541439176OtherTAX ID