Provider Demographics
NPI:1659534998
Name:MENEZES, BHAVISHA (MD)
Entity Type:Individual
Prefix:DR
First Name:BHAVISHA
Middle Name:
Last Name:MENEZES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:BHAVISHA
Other - Middle Name:
Other - Last Name:DIXIT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:11580 CEDAR CHASE RD
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20170-2474
Mailing Address - Country:US
Mailing Address - Phone:917-224-7432
Mailing Address - Fax:
Practice Address - Street 1:1890 METRO CENTER DR
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-5286
Practice Address - Country:US
Practice Address - Phone:703-709-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-08
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0069205207V00000X
DCMD038253207V00000X
VA0101245812207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology