Provider Demographics
NPI:1932206406
Name:TANDJEU, DENISE TANDJEU (MD)
Entity Type:Individual
Prefix:DR
First Name:DENISE
Middle Name:TANDJEU
Last Name:TANDJEU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:785 5TH AVENUE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-4232
Mailing Address - Country:US
Mailing Address - Phone:717-263-9555
Mailing Address - Fax:
Practice Address - Street 1:501 E. MAIN STREET
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:PA
Practice Address - Zip Code:17268
Practice Address - Country:US
Practice Address - Phone:717-765-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-19
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101240377207R00000X
PAMD430402207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1559228OtherGATEWAY
PA25-1716306OtherSOUTH CENTRAL PREFERRED
PA25-1716306OtherINTERGROUP
PA5745667OtherFIRST HEALTH
PAP00377946OtherRAILROAD MEDICARE
PA263104OtherUNISON
PAV109-0015OtherCAREFIRST DC
PA25-1716306OtherGREATWEST HEALTHCARE
PA7204872OtherAETNA NON-HMO
PA913385-01OtherCAREFIRST MD
PA1018056250001Medicaid
PA25-1716306OtherINFORMED
PA25-1716306OtherHEALTHNET/TRICARE
PATA1936321OtherHIGHMARK BLUESHIELD
PA690719OtherHEALTH AMERICA
PA1007307260034OtherMEDICAID GROUP #
PA120420407OtherDEPT OF LABOR
PA1457805OtherAETNA HMO
PA2165443OtherMAMSI
PA25-1716306OtherDEVON
PA25-1716306OtherMULTIPLAN/PHCS
PA50065196OtherCAPITAL BLUECROSS
PA867633OtherMEDICARE GROUP #
PAMD430402OtherLICENSE
PAMD430402OtherLICENSE
PA25-1716306OtherHEALTHNET/TRICARE
PA25-1716306OtherINTERGROUP