Individual
SURUCHI BHARDWAJ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2955 IVY RD STE 300, CHARLOTTESVILLE, VA 22903
(434) 924-5485
(434) 243-4784
Mailing address
PO BOX 9007, CHARLOTTESVILLE, VA 22906-9007
(434) 295-1000
(434) 972-4266
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
0101264189
VA
390200000X
Student in an Organized Health Care Education/Training Program
MT205765
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1548670417
—
VA
Enumeration date
05/01/2014
Last updated
06/29/2018
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