Provider Demographics
NPI:1619943420
Name:VERMA, PRIYA S (PA)
Entity Type:Individual
Prefix:
First Name:PRIYA
Middle Name:S
Last Name:VERMA
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:55 WHITCHER ST NE STE 260
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-1169
Mailing Address - Country:US
Mailing Address - Phone:943-202-7050
Mailing Address - Fax:470-986-7016
Practice Address - Street 1:55 WHITCHER ST NE STE 260
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-1169
Practice Address - Country:US
Practice Address - Phone:943-202-7050
Practice Address - Fax:470-986-7016
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA003637363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA199990121AMedicaid
GA199990121BMedicaid
GA199990121AMedicaid