Provider Demographics
NPI:1508846676
Name:CHANDOS, BRANDON J (MD)
Entity type:Individual
Prefix:
First Name:BRANDON
Middle Name:J
Last Name:CHANDOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:495 COOPER RD STE 212
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-8735
Mailing Address - Country:US
Mailing Address - Phone:614-627-1400
Mailing Address - Fax:614-882-6097
Practice Address - Street 1:495 COOPER RD STE 212
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-8735
Practice Address - Country:US
Practice Address - Phone:614-627-1400
Practice Address - Fax:614-882-6097
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH351214772084S0012X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0086499Medicaid
G28418Medicare UPIN
OH0086499Medicaid