MEDICARE: VIJAY ALLURI VARMA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	029547	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	029547	OTHER	GA	MEDICAL LICENSE

General Provider Information

NPI Number	:	1417907890
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VIJAY ALLURI VARMA M.D.

Provider Business Mailing Address
First Line	:	VA MEDICAL CENTER LAB SERVICES
Second Line	:	1670 CLAIRMONT RD.
City	:	DECATUR
State	:	GA
Zip	:	30033
Country	:	US
Telephone Number	:	404-235-3010
Fax Number	:	404-235-3007

Provider Business Practice Location Address
First Line	:	VA MEDICAL CENTER LAB SERVICES
Second Line	:	1670 CLAIRMONT RD.
City	:	DECATUR
State	:	GA
Zip	:	30033
Country	:	US
Telephone Number	:	404-235-3010
Fax Number	:	404-235-3007

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/10/2006
Last Update Date	:	07/08/2007

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