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General NPI Number Information
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NPI Number | 1336502798
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Entity Type | Individual
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Provider Name | SIDDHARTH VERMA M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/03/2016
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Last Update Date | 07/23/2021
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Provider Practice Location Address
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Address Line | 418 GRAND PARK DR STE 311
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City | PARKERSBURG
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State | WV
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Zip | 26105-4000
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Country | US
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Telephone | 304-865-5026
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Fax |
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Provider Business Mailing Address
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Address Line | 100 AQUA WAY APT 136
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City | NEWPORT
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State | KY
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Zip | 41071-2198
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Country | US
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Telephone | 978-626-2525
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 57.250119
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 30459
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License Number State | WV
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