Provider Demographics
NPI:1033155528
Name:SUNHIL P VERMA MD MPH INC
Entity Type:Organization
Organization Name:SUNHIL P VERMA MD MPH INC
Other - Org Name:SUNHIL P VERMA MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGED CARE SPEC ALLSCRIPTS
Authorized Official - Prefix:
Authorized Official - First Name:DIRENDIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHACKELFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-654-0889
Mailing Address - Street 1:300 TOLL GATE RD
Mailing Address - Street 2:STE 301C
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-4416
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:300 TOLL GATE RD
Practice Address - Street 2:STE 301C
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-4416
Practice Address - Country:US
Practice Address - Phone:401-732-1700
Practice Address - Fax:401-732-9682
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-21
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD10322332900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site
Provider Identifiers
StateIdentifier IDID TypeIssuer
4106604OtherOTHER ID NUMBER-COMMERCIAL NUMBER
RISV51405Medicaid