Healthcare Provider Details

I. General information

NPI: 1316104227
Provider Name (Legal Business Name): USHA VARMA M. D PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2008
Last Update Date: 05/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

821 N EUTAW ST SUITE 308
BALTIMORE MD
21201-4648
US

IV. Provider business mailing address

821 N EUTAW ST SUITE 308
BALTIMORE MD
21201-4648
US

V. Phone/Fax

Practice location:
  • Phone: 410-581-8767
  • Fax: 410-581-9017
Mailing address:
  • Phone: 410-581-8767
  • Fax: 410-581-9017

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberD0015066
License Number StateMD

VIII. Authorized Official

Name: DR. USHA W VARMA
Title or Position: OWNER
Credential: MD
Phone: 410-581-8767