Provider Demographics
NPI:1891257226
Name:BATHEJA, VAIBHAV
Entity type:Individual
Prefix:
First Name:VAIBHAV
Middle Name:
Last Name:BATHEJA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 FALL HILL AVE STE 317
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-3343
Mailing Address - Country:US
Mailing Address - Phone:540-741-4257
Mailing Address - Fax:
Practice Address - Street 1:125 HOSPITAL CENTER BLVD STE 200
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22554-6202
Practice Address - Country:US
Practice Address - Phone:540-374-3212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-04
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102208752208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine