Provider Demographics
NPI:1699735936
Name:VERMA, ASHISH (MD)
Entity type:Individual
Prefix:
First Name:ASHISH
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 1:1717 E CHICAGO RD
Mailing Address - Street 2:
Mailing Address - City:STURGIS
Mailing Address - State:MI
Mailing Address - Zip Code:49091-8524
Mailing Address - Country:US
Mailing Address - Phone:269-651-4744
Mailing Address - Fax:269-659-4998
Practice Address - Street 1:1717 E CHICAGO RD
Practice Address - Street 2:
Practice Address - City:STURGIS
Practice Address - State:MI
Practice Address - Zip Code:49091-8524
Practice Address - Country:US
Practice Address - Phone:269-651-4744
Practice Address - Fax:269-659-4998
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2012-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301079056207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4693323Medicaid
MI104379515Medicaid
MIH48042Medicare UPIN
MI4693323Medicaid
MI0G56212016Medicare PIN
MIC96065041Medicare PIN