Provider Demographics
NPI:1891751806
Name:VERMA, UMESH (MD)
Entity Type:Individual
Prefix:
First Name:UMESH
Middle Name:
Last Name:VERMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:DEPARTMENT 272801
Mailing Address - Street 2:PO BOX 67000
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48267-2728
Mailing Address - Country:US
Mailing Address - Phone:517-841-6913
Mailing Address - Fax:517-841-6917
Practice Address - Street 1:1418 E MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49202-3518
Practice Address - Country:US
Practice Address - Phone:517-783-5448
Practice Address - Fax:517-784-8705
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2007-11-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI43010723782084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI104749106Medicaid
MI104597739Medicaid
MIP00082843OtherRR MEDICARE
MIM95720016Medicare PIN
MI104749106Medicaid
MIM95720016Medicare UPIN
MIN53130050Medicare UPIN