Provider Demographics
NPI:1740551308
Name:SUJIT R VARMA, MD
Entity type:Organization
Organization Name:SUJIT R VARMA, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUJIT
Authorized Official - Middle Name:R
Authorized Official - Last Name:VARMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-241-4050
Mailing Address - Street 1:7945 STONE CREEK DR
Mailing Address - Street 2:SUITE 130
Mailing Address - City:CHANHASSEN
Mailing Address - State:MN
Mailing Address - Zip Code:55317-4605
Mailing Address - Country:US
Mailing Address - Phone:952-241-4050
Mailing Address - Fax:952-241-4049
Practice Address - Street 1:7945 STONE CREEK DR
Practice Address - Street 2:SUITE 130
Practice Address - City:CHANHASSEN
Practice Address - State:MN
Practice Address - Zip Code:55317-4605
Practice Address - Country:US
Practice Address - Phone:952-241-4050
Practice Address - Fax:952-241-4049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-13
Last Update Date:2012-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN480762084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty