1184726770 NPI number — VIVEK VARMA, MD, PA

Table of content: (NPI 1184726770)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184726770 NPI number — VIVEK VARMA, MD, PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VIVEK VARMA, MD, PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1184726770
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/03/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 565
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ELKTON
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21922-0565
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
206 SOUTH ST
Provider Second Line Business Practice Location Address:
SUITE C
Provider Business Practice Location Address City Name:
ELKTON
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21921-5633
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-620-4920
Provider Business Practice Location Address Fax Number:
410-620-4922
Provider Enumeration Date:
09/02/2006

Additional Information

Authorized Official

Authorized Official Last Name:
VARMA
Authorized Official First Name:
VIVEK
Authorized Official Middle Name:
KUMAR
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
410-620-4920

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X , with the licence number:  D35832 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1000035504 , issued by the state of ( DE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2344064000 . This is a "KEYSTONE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 669808 . This is a "HIGHMARK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7277VK . This is a "BCBS MD" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: DC7493 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: E366 . This is a "BCBS DC" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 51468 . This is a "COVENTRY" identifier . This identifiers is of the category "OTHER".




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