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NPI Code Detail

MEDICARE: AJAY KUMAR VARMA BUDDARAJU MD

MEDICARE: AJAY KUMAR VARMA BUDDARAJU MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RR0500XRheumatology Physician35090971OH

General Provider Information

NPI Number : 1548247448
Entity Type Code : Individual
Provider Name (Legal Business Name) : AJAY KUMAR VARMA BUDDARAJU MD
Provider Business Mailing Address
First Line : 101 E MILLER RD
Second Line :
City : STERLING
State : IL
Zip : 61081-1252
Country : US
Telephone Number : 815-625-4790
Fax Number :
Provider Business Practice Location Address
First Line : 101 E MILLER RD
Second Line :
City : STERLING
State : IL
Zip : 61081-1252
Country : US
Telephone Number : 815-625-4790
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/30/2005
Last Update Date : 07/10/2012

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