Healthcare Provider Details

I. General information

NPI: 1972720225
Provider Name (Legal Business Name): SHALINI VERMA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHALINI RAWAL MD

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 08/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2006 LIMESTONE RD
WILMINGTON DE
19808-5553
US

IV. Provider business mailing address

504 HARVEST GROVE TRAIL
DOVER DE
19901
US

V. Phone/Fax

Practice location:
  • Phone: 302-355-2383
  • Fax: 302-351-6261
Mailing address:
  • Phone: 302-588-9199
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD-443728
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number2014012872
License Number StateMO
# 3
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberD0079923
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: