Provider Demographics
NPI:1497735815
Name:VERMA, PUJA (MD)
Entity Type:Individual
Prefix:
First Name:PUJA
Middle Name:
Last Name:VERMA
Suffix:
Gender:F
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:PO BOX 42210
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85080-2210
Mailing Address - Country:US
Mailing Address - Phone:623-889-7403
Mailing Address - Fax:623-889-7407
Practice Address - Street 1:1255 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85281-1210
Practice Address - Country:US
Practice Address - Phone:602-685-5211
Practice Address - Fax:623-889-7407
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ32648207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ79235Medicare PIN
I03294Medicare UPIN
AZZ79243Medicare PIN