Healthcare Provider Details

I. General information

NPI: 1427440718
Provider Name (Legal Business Name): RUNJHUN BHATIA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/24/2015
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date: 04/30/2019
Reactivation Date: 05/22/2019

III. Provider practice location address

11958 W BROAD ST FL 5
HENRICO VA
23233-1007
US

IV. Provider business mailing address

11958 W BROAD ST FL 5
HENRICO VA
23233-1007
US

V. Phone/Fax

Practice location:
  • Phone: 804-828-9350
  • Fax:
Mailing address:
  • Phone: 804-828-9350
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number01090913A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: