Provider Demographics
NPI:1427052893
Name:VERMA, SAMEER (MD)
Entity type:Individual
Prefix:
First Name:SAMEER
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 1:6619 GREEN VALLEY CIR
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-7016
Mailing Address - Country:US
Mailing Address - Phone:862-252-0195
Mailing Address - Fax:
Practice Address - Street 1:6619 GREEN VALLEY CIR
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-7016
Practice Address - Country:US
Practice Address - Phone:862-252-0195
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-13
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07600600174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8885303Medicaid
NJ8885303Medicaid
CACE130ZMedicare PIN
NJ078460Medicare ID - Type Unspecified