Healthcare Provider Details

I. General information

NPI: 1548964182
Provider Name (Legal Business Name): VISHISHYA BHATNAGAR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2023
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3833 FAIRFAX DR STE 200
ARLINGTON VA
22203-1773
US

IV. Provider business mailing address

3833 FAIRFAX DR STE 200
ARLINGTON VA
22203-1773
US

V. Phone/Fax

Practice location:
  • Phone: 703-525-8863
  • Fax: 703-525-2387
Mailing address:
  • Phone: 703-525-8863
  • Fax: 703-525-2387

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0101288609
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: