Basic Information
Provider Information
NPI: 1376533182
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHANDY
FirstName: JOBY
MiddleName: J
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3100 SPRING FOREST RD
Address2: STE 130
City: RALEIGH
State: NC
PostalCode: 276162880
CountryCode: US
TelephoneNumber: 9198827908
FaxNumber: 9198739821
Practice Location
Address1: 3300 GALLOWS ROAD
Address2:  
City: FALLS CHURCH
State: VA
PostalCode: 220423307
CountryCode: US
TelephoneNumber: 7037763138
FaxNumber: 6177248500
Other Information
ProviderEnumerationDate: 10/24/2005
LastUpdateDate: 09/14/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/14/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XME155833FLN Allopathic & Osteopathic PhysiciansAnesthesiology 
207LC0200X226647MAN Allopathic & Osteopathic PhysiciansAnesthesiologyCritical Care Medicine
207L00000X0101243404VAY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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