Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 2001016023 | MO |
N | 111NI0900X | Internist | 2001016023 | MO |
Y | 207RH0003X | Hematology & Oncology | 2001016023 | MO |
N | 207RX0202X | Medical Oncology | 2001016023 | MO |
NPI | 1164477014 |
---|---|
Provider Name | Dushyant Verma |
First Address | Atlanta, GA 30368-7287 |
Second Address | Springfield, MO 65807-5230 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2006 |
Last Update Date | 02/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
205838808 | (05) | MO |
H49424 | (02) | MO |