Provider Demographics
NPI:1871658906
Name:VARSHNEY, SMITA UPKAR (MD)
Entity Type:Individual
Prefix:
First Name:SMITA
Middle Name:UPKAR
Last Name:VARSHNEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SMITA
Other - Middle Name:
Other - Last Name:GUGALE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:420 E 2ND AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30161-3209
Mailing Address - Country:US
Mailing Address - Phone:706-509-3278
Mailing Address - Fax:
Practice Address - Street 1:306 SHORTER AVE NW
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30165-4268
Practice Address - Country:US
Practice Address - Phone:706-509-3278
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2010-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0459972084P0800X, 2084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000874134AMedicaid
H20979Medicare UPIN
GA26BDHGPMedicare ID - Type Unspecified