Healthcare Provider Details

I. General information

NPI: 1548796642
Provider Name (Legal Business Name): HARNEK BAJAJ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2017
Last Update Date: 11/26/2024
Certification Date: 11/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1776 CAMBRIDGE DR
RICHMOND VA
23238-3203
US

IV. Provider business mailing address

8401 MAYLAND DR STE 4823
RICHMOND VA
23294-4648
US

V. Phone/Fax

Practice location:
  • Phone: 804-368-6474
  • Fax:
Mailing address:
  • Phone: 804-368-6474
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number0101276118
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number0101276118
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number0101276118
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: