Provider Demographics
NPI:1194800037
Name:VERMA, DIVYA (MD)
Entity type:Individual
Prefix:DR
First Name:DIVYA
Middle Name:
Last Name:VERMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:702 SOUTH UNION STREET
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4000 MITCHELLVILLE ROAD
Practice Address - Street 2:SUITE A406
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716
Practice Address - Country:US
Practice Address - Phone:301-262-0400
Practice Address - Fax:301-262-0300
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0052298207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
223280OtherMAMSI
2463908OtherAETNA
MD223350900Medicaid
49916OtherAMERIGROUP
1668841004OtherCIGNA
MD5287 0001OtherCAREFIRST
MD440003220OtherRAILROAD MEDICARE