Provider Demographics
NPI:1730201096
Name:VERMA, GAURAV KUMAR (MD)
Entity type:Individual
Prefix:
First Name:GAURAV
Middle Name:KUMAR
Last Name:VERMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:476 BUCKEYE ST
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47804-4079
Mailing Address - Country:US
Mailing Address - Phone:812-238-4708
Mailing Address - Fax:812-238-4718
Practice Address - Street 1:476 BUCKEYE ST
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47804-4079
Practice Address - Country:US
Practice Address - Phone:812-238-4708
Practice Address - Fax:812-238-4718
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-05
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01067346207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
M400018357Medicare PIN