=====================================================
General NPI Number Information
=====================================================
NPI Number | 1255480976
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ABHA G. VARMA MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/10/2007
-----------------------------------------------------
Last Update Date | 11/22/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2040 RAYBROOK ST SE STE 200
-----------------------------------------------------
City | GRAND RAPIDS
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49546-7718
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 616-386-4260
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2040 RAYBROOK ST SE STE 200
-----------------------------------------------------
City | GRAND RAPIDS
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49546-7718
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 616-386-4260
-----------------------------------------------------
Fax | 616-341-7509
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | 4301072430
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------