Basic Information
| Provider Information | |||||||||
| NPI: | 1932206406 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TANDJEU | ||||||||
| FirstName: | DENISE | ||||||||
| MiddleName: | TANDJEU | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 785 5TH AVENUE | ||||||||
| Address2: | SUITE 3 | ||||||||
| City: | CHAMBERSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 172014232 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7172639555 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 501 E. MAIN STREET | ||||||||
| Address2: | |||||||||
| City: | WAYNESBORO | ||||||||
| State: | PA | ||||||||
| PostalCode: | 17268 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7177654000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/19/2006 | ||||||||
| LastUpdateDate: | 01/19/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 0101240377 | VA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | MD430402 | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | MD430402 | PA | N | Allopathic & Osteopathic Physicians | Hospitalist |
ID Information
| ID | Type | State | Issuer | Description | 1559228 | 01 | PA | GATEWAY | OTHER | 25-1716306 | 01 | PA | SOUTH CENTRAL PREFERRED | OTHER | 25-1716306 | 01 | PA | INTERGROUP | OTHER | 5745667 | 01 | PA | FIRST HEALTH | OTHER | P00377946 | 01 | PA | RAILROAD MEDICARE | OTHER | 263104 | 01 | PA | UNISON | OTHER | V109-0015 | 01 | PA | CAREFIRST DC | OTHER | 25-1716306 | 01 | PA | GREATWEST HEALTHCARE | OTHER | 7204872 | 01 | PA | AETNA NON-HMO | OTHER | 913385-01 | 01 | PA | CAREFIRST MD | OTHER | 1018056250001 | 05 | PA | MEDICAID | 25-1716306 | 01 | PA | INFORMED | OTHER | 25-1716306 | 01 | PA | HEALTHNET/TRICARE | OTHER | TA1936321 | 01 | PA | HIGHMARK BLUESHIELD | OTHER | 690719 | 01 | PA | HEALTH AMERICA | OTHER | 1007307260034 | 01 | PA | MEDICAID GROUP # | OTHER | 120420407 | 01 | PA | DEPT OF LABOR | OTHER | 1457805 | 01 | PA | AETNA HMO | OTHER | 2165443 | 01 | PA | MAMSI | OTHER | 25-1716306 | 01 | PA | DEVON | OTHER | BT9930086 | 01 | PA | DEA | OTHER | 25-1716306 | 01 | PA | MULTIPLAN/PHCS | OTHER | 50065196 | 01 | PA | CAPITAL BLUECROSS | OTHER | 867633 | 01 | PA | MEDICARE GROUP # | OTHER | MD430402 | 01 | PA | LICENSE | OTHER |