Provider Demographics
NPI:1376118646
Name:VERMA, KHUSHBOO (MBBS)
Entity Type:Individual
Prefix:
First Name:KHUSHBOO
Middle Name:
Last Name:VERMA
Suffix:
Gender:F
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4301 WEST MARKHAM
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205
Mailing Address - Country:US
Mailing Address - Phone:501-296-1165
Mailing Address - Fax:501-526-6266
Practice Address - Street 1:4301 WEST MARKHAM
Practice Address - Street 2:#500
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205
Practice Address - Country:US
Practice Address - Phone:501-686-5135
Practice Address - Fax:501-526-6266
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-20
Last Update Date:2022-12-22
Deactivation Date:2022-11-07
Deactivation Code:
Reactivation Date:2022-12-22
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program