Provider Demographics
NPI:1992715247
Name:VERB, PATRICK M (MD)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:M
Last Name:VERB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:33080 UTICA RD
Mailing Address - Street 2:
Mailing Address - City:FRASER
Mailing Address - State:MI
Mailing Address - Zip Code:48026-2038
Mailing Address - Country:US
Mailing Address - Phone:586-296-7250
Mailing Address - Fax:586-296-7256
Practice Address - Street 1:11441 E 12 MILE RD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48093-2639
Practice Address - Country:US
Practice Address - Phone:586-756-5060
Practice Address - Fax:586-596-9783
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2024-11-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MIPV033783207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIAV5984643OtherDEA
MI1992715247Medicaid
MIAV5984643OtherDEA
MI1184575Medicaid