MEDICARE: DR. SIDDHARTH BAJPAI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	R-8537	IA
2	2084P0800X	Psychiatry Physician	0101260238	VA

General Provider Information

NPI Number	:	1093945727
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SIDDHARTH BAJPAI M.D.

Provider Business Mailing Address
First Line	:	8500 EXECUTIVE PARK AVE
Second Line	:	STE 200
City	:	FAIRFAX
State	:	VA
Zip	:	22031-2228
Country	:	US
Telephone Number	:	319-356-1616
Fax Number	:

Provider Business Practice Location Address
First Line	:	8500 EXECUTIVE PARK AVE
Second Line	:	STE 200
City	:	FAIRFAX
State	:	VA
Zip	:	22031-2228
Country	:	US
Telephone Number	:	319-356-1616
Fax Number	:	703-573-2351

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/15/2009
Last Update Date	:	08/02/2016

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