Healthcare Provider Details

I. General information

NPI: 1255399671
Provider Name (Legal Business Name): DEIDRA L. VARNER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6710 OXON HILL ROAD SUITE 250
OXON HILL MD
20745-1124
US

IV. Provider business mailing address

PO BOX 640
HOLLYWOOD MD
20636-0640
US

V. Phone/Fax

Practice location:
  • Phone: 301-292-7270
  • Fax: 301-203-0740
Mailing address:
  • Phone: 301-373-7900
  • Fax: 301-373-6900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberD0033512
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberD33512
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: