Provider Demographics
NPI:1073577474
Name:VERMA, ASHISH (MD)
Entity Type:Individual
Prefix:DR
First Name:ASHISH
Middle Name:
Last Name:VERMA
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 1:2030 SPRINGBROOK S
Mailing Address - Street 2:
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53186-1201
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:721 AMERICAN AVE
Practice Address - Street 2:SUITE 409
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188-5071
Practice Address - Country:US
Practice Address - Phone:262-928-8610
Practice Address - Fax:262-928-8615
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2010-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WIWI39177-020207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI32504900Medicaid
WI32504900Medicaid
WI000168995Medicare ID - Type UnspecifiedDR. VERMA
WIG86969Medicare UPIN