Provider Demographics
NPI:1376032995
Name:DAS, VARSHA
Entity Type:Individual
Prefix:
First Name:VARSHA
Middle Name:
Last Name:DAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23061 JULIEANN CT
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48335-4076
Mailing Address - Country:US
Mailing Address - Phone:248-943-9380
Mailing Address - Fax:
Practice Address - Street 1:1801 MEHARRY BLVD
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37208
Practice Address - Country:US
Practice Address - Phone:615-327-6844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-09
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TN390200000X
MI4351042211208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program