Individual
ALI KASSAMALI CHANDANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3600 JOSEPH SIEWICK DR, FAIRFAX, VA 22033-1709
(703) 391-3129
Mailing address
PO BOX 3120, STE 300, NORTH FORT MYERS, FL 33918-3120
(703) 766-9737
(703) 766-9725
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
0101240896
VA
207L00000X
Anesthesiology Physician
D62061
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010357349
—
VA
05
—
010359520
—
VA
05
—
010359627
—
VA
05
—
010360081
—
VA
01
—
139230
ANTHEM
VA
05
—
406953600
—
MD
01
—
484645
NCPPO
VA
01
—
K142-0001
CAREFIRST
VA
Enumeration date
05/08/2006
Last updated
02/23/2016
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