MEDICARE: DR. BHAVIN S SUTHAR MD

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	174400000X	Specialist	0101239456	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	350742	OTHER	VA	ANTHEM
3	1376574459	OTHER		NPI

General Provider Information

NPI Number	:	1376574459
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BHAVIN S SUTHAR MD

Provider Business Mailing Address
First Line	:	3310 FALL HILL AVE
Second Line	:
City	:	FREDERICKSBURG
State	:	VA
Zip	:	22401-3000
Country	:	US
Telephone Number	:	540-374-3233
Fax Number	:	540-374-3234

Provider Business Practice Location Address
First Line	:	4710 SPOTSYLVANIA PKWY
Second Line	:	SUITE 201
City	:	FREDERICKSBURG
State	:	VA
Zip	:	22407-9433
Country	:	US
Telephone Number	:	540-374-3233
Fax Number	:	540-374-3234

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

Provider Enumeration Date	:	07/06/2006
Last Update Date	:	05/28/2015

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