Provider Demographics
NPI:1841670270
Name:VARMA, SAURABH KUMAR (DO)
Entity type:Individual
Prefix:
First Name:SAURABH
Middle Name:KUMAR
Last Name:VARMA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5501 BACKLICK RD STE 118
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22151-3940
Mailing Address - Country:US
Mailing Address - Phone:252-314-4657
Mailing Address - Fax:
Practice Address - Street 1:5501 BACKLICK RD STE 118
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22151-3940
Practice Address - Country:US
Practice Address - Phone:252-314-4657
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-01
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0065442208D00000X
390200000X
VA0102206505208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program