Provider Demographics
NPI:1295777191
Name:BATEMAN, BRUCE G (MD)
Entity type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:G
Last Name:BATEMAN
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 1:595 PETER JEFFERSON PKWY
Mailing Address - Street 2:SUITE 390
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-4627
Mailing Address - Country:US
Mailing Address - Phone:434-654-8520
Mailing Address - Fax:434-654-8521
Practice Address - Street 1:595 MARTHA JEFFERSON DR STE 390
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-4669
Practice Address - Country:US
Practice Address - Phone:434-654-8524
Practice Address - Fax:434-654-8521
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-12
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101031852207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA10000202Medicaid
VA183487OtherANTHEM SVCS/HEALTHKEEPERS
VA010198437Medicaid
VA317105OtherSOUTHERN HEALTH
VA183487Medicaid
VA2136403OtherMAMSI
VA1455099OtherCIGNA
VA10000202OtherCOMMUNITY HEALTH
B08140Medicare UPIN
VA010198437Medicaid