Basic Information
| Provider Information | |||||||||
| NPI: | 1407857022 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHANDLER | ||||||||
| FirstName: | CANDACE | ||||||||
| MiddleName: | IRENE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2101 E JEFFERSON ST | ||||||||
| Address2: | KAISER PERMANENTE MEDICARE ENROLLMENT | ||||||||
| City: | ROCKVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208524908 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3018162424 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1447 YORK RD STE 100 | ||||||||
| Address2: | KAISER PERMANENTE TOWSON MEDICAL OFFICE | ||||||||
| City: | LUTHERVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210936038 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4103395500 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/04/2005 | ||||||||
| LastUpdateDate: | 12/04/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | D0029209 | MD | Y | Allopathic & Osteopathic Physicians | Family Medicine | 207QA0505X | 0101248787 | VA | N | Allopathic & Osteopathic Physicians | Family Medicine | Adult Medicine | 207QA0505X | MD039437 | DC | N | Allopathic & Osteopathic Physicians | Family Medicine | Adult Medicine |
No ID Information.