Provider Demographics
NPI:1184726770
Name:VIVEK VARMA, MD, PA
Entity type:Organization
Organization Name:VIVEK VARMA, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VIVEK
Authorized Official - Middle Name:KUMAR
Authorized Official - Last Name:VARMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-620-4920
Mailing Address - Street 1:PO BOX 565
Mailing Address - Street 2:
Mailing Address - City:ELKTON
Mailing Address - State:MD
Mailing Address - Zip Code:21922-0565
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:206 SOUTH ST
Practice Address - Street 2:SUITE C
Practice Address - City:ELKTON
Practice Address - State:MD
Practice Address - Zip Code:21921-5633
Practice Address - Country:US
Practice Address - Phone:410-620-4920
Practice Address - Fax:410-620-4922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-02
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD35832207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1000035504Medicaid
2344064000OtherKEYSTONE
669808OtherHIGHMARK
MD7277VKOtherBCBS MD
MDDC7493OtherRAILROAD MEDICARE
DCE366OtherBCBS DC
51468OtherCOVENTRY
669808OtherHIGHMARK
2344064000OtherKEYSTONE
51468OtherCOVENTRY