Provider Demographics
NPI:1922142314
Name:VERMA, NEELAM (MD)
Entity Type:Individual
Prefix:MRS
First Name:NEELAM
Middle Name:
Last Name:VERMA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 BELLE MEADE ST
Mailing Address - Street 2:
Mailing Address - City:GROSSE POINTE SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48236-1552
Mailing Address - Country:US
Mailing Address - Phone:313-881-0071
Mailing Address - Fax:313-881-8438
Practice Address - Street 1:49 BELLE MEADE ST
Practice Address - Street 2:
Practice Address - City:GROSSE POINTE SHORES
Practice Address - State:MI
Practice Address - Zip Code:48236-1552
Practice Address - Country:US
Practice Address - Phone:313-881-0071
Practice Address - Fax:313-881-8438
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-18
Last Update Date:2009-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010474732084P0800X, 2084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI101967326Medicaid
MIOEO7664OtherBCBS
MIE49508Medicare UPIN
MIOEO7664OtherBCBS