Healthcare Provider Details
I. General information
NPI: 1750461000
Provider Name (Legal Business Name): USHA W VARMA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
821 N EUTAW ST STE 308
BALTIMORE MD
21201-4648
US
IV. Provider business mailing address
821 N EUTAW ST STE 308
BALTIMORE MD
21201-4648
US
V. Phone/Fax
- Phone: 410-581-8767
- Fax: 410-581-9107
- Phone: 410-581-8767
- Fax: 410-581-9107
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VG0400X |
| Taxonomy | Gynecology Physician |
| License Number | D0015066 |
| License Number State | MD |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: