Individual
DR. SANDRA TIRADO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
10530 ROSEHAVEN ST STE 100, FAIRFAX, VA 22030-2888
(703) 938-0363
(703) 938-8653
Mailing address
PO BOX 37189, BALTIMORE, MD 21297-3189
(571) 423-5699
(571) 423-5698
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101038420
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6071767
—
VA
Enumeration date
08/31/2005
Last updated
01/20/2022
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