Doctor Name: | VANESSA VARMA |
NPI Number: | 1093010118 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | 5601005953 |
Business Practice Address: | 2025 Ford Ave Ste. 100 Wyandotte, MI - 481922312 |
Business Phone Number: | 5866123556 |
Business Fax Number: | |
Mailing Address: | 4003 Dukeshire Hwy, ROYAL OAK |
State: | MI |
Postal Code: | 480736435 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 01/20/2011 |
NPI Last Update Date: | 02/19/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 5601005953 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |