Provider Demographics
NPI:1013018258
Name:VARMA, SUJIT RAM (MD)
Entity Type:Individual
Prefix:DR
First Name:SUJIT
Middle Name:RAM
Last Name:VARMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4444 W 76TH ST STE 400
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-5178
Mailing Address - Country:US
Mailing Address - Phone:612-746-5888
Mailing Address - Fax:612-746-5518
Practice Address - Street 1:4444 W 76TH ST STE 400
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-5178
Practice Address - Country:US
Practice Address - Phone:612-746-5888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN480762084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN252133000Medicaid
MN260002511Medicare ID - Type Unspecified
I41335Medicare UPIN