Provider Demographics
NPI:1649238213
Name:VERMA, ASHISH (MD)
Entity Type:Individual
Prefix:
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 1:2177 AUBURN RD
Mailing Address - Street 2:
Mailing Address - City:SHELBY TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48317-3806
Mailing Address - Country:US
Mailing Address - Phone:586-737-7520
Mailing Address - Fax:586-737-7591
Practice Address - Street 1:2177 AUBURN RD
Practice Address - Street 2:
Practice Address - City:SHELBY TWP
Practice Address - State:MI
Practice Address - Zip Code:48317-3806
Practice Address - Country:US
Practice Address - Phone:586-737-7520
Practice Address - Fax:586-737-7591
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301066588207R00000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1106352561OtherBCBS
MI1649238213Medicaid
MI1649238213Medicaid
MIMI6729Medicare PIN