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General NPI Number Information
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NPI Number | 1679648356
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Entity Type | Individual
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Provider Name | SUMIT VERMA M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/21/2006
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Last Update Date | 08/02/2013
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Provider Practice Location Address
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Address Line | 2514 S 102ND ST SUITE 160
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City | WEST ALLIS
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State | WI
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Zip | 53227-2142
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Country | US
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Telephone | 414-225-0300
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Fax | 414-543-9601
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Provider Business Mailing Address
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Address Line | PO BOX 1239
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City | TROY
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State | MI
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Zip | 48099-1239
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Country | US
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Telephone | 248-824-6600
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Fax | 248-324-1477
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 52113-020
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License Number State | WI
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