1699776559 NPI number — SANDEEP RAHANGDALE M.D.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699776559 NPI number — SANDEEP RAHANGDALE M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RAHANGDALE
Provider First Name:
SANDEEP
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1699776559
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/15/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
WALTER REED NATIONAL MILITARY MEDICAL CENTER
Provider Second Line Business Mailing Address:
4494 PALMER RD N
Provider Business Mailing Address City Name:
BETHESDA
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20889-0001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
850-766-8496
Provider Business Mailing Address Fax Number:
850-210-0315

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
WALTER REED NATIONAL MILITARY MEDICAL CENTER
Provider Second Line Business Practice Location Address:
4494 PALMER RD N
Provider Business Practice Location Address City Name:
BETHESDA
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20889-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
850-766-8496
Provider Business Practice Location Address Fax Number:
850-210-0315
Provider Enumeration Date:
08/02/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  ME72888 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: SG058336 . This is a "VISTA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 42844 . This is a "BCBS OF FLORIDA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 00000 . This is a "SOUTH CARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 00000 . This is a "HUMANA/CHOICE CARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 00000 . This is a "MULTIPLAN" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 00000 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 00000 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 00000 . This is a "BEECH ST/CAPP CARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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