Provider Demographics
NPI:1245428663
Name:BHATT, KIRIT (MD)
Entity Type:Individual
Prefix:DR
First Name:KIRIT
Middle Name:
Last Name:BHATT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 CHAIN BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-3935
Mailing Address - Country:US
Mailing Address - Phone:703-574-4955
Mailing Address - Fax:703-483-9986
Practice Address - Street 1:1300 CHAIN BRIDGE RD
Practice Address - Street 2:
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-3935
Practice Address - Country:US
Practice Address - Phone:703-574-4955
Practice Address - Fax:703-483-9986
Is Sole Proprietor?:No
Enumeration Date:2007-10-10
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA64331208200000X
CA52988208200000X
VA01012543862082S0099X, 208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No2082S0099XAllopathic & Osteopathic PhysiciansPlastic SurgeryPlastic Surgery Within the Head and Neck