Provider Demographics
NPI:1790873248
Name:VERMA, SHRI KRIS (MD)
Entity Type:Individual
Prefix:
First Name:SHRI
Middle Name:KRIS
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 1:391 OCEAN AVENUE
Mailing Address - Street 2:
Mailing Address - City:NEW LONDON
Mailing Address - State:CT
Mailing Address - Zip Code:06320-4717
Mailing Address - Country:US
Mailing Address - Phone:860-447-2489
Mailing Address - Fax:860-437-1231
Practice Address - Street 1:391 OCEAN AVENUE
Practice Address - Street 2:
Practice Address - City:NEW LONDON
Practice Address - State:CT
Practice Address - Zip Code:06320-4717
Practice Address - Country:US
Practice Address - Phone:860-447-2489
Practice Address - Fax:860-437-1231
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT039351207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
F81040Medicare UPIN