Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | 36114249 | IL |
Y | 207RP1001X | Pulmonary Disease | 036-114249 | IL |
NPI | 1073525770 |
---|---|
Provider Name | Rajeev Varma |
First Address | Bloomington, IL 61701-7912 |
Second Address | Bloomington, IL 61701-7912 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2006 |
Last Update Date | 13/01/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036114249 2 | (05) | IL |
1073525770 | (05) | WI |
4673170001 | DMERC (01) | IL |
P00457730/CK6882 | RAIL ROAD MEDICARE (01) | IL |
P00624444CG6042 | RAILROAD MEDICARE (01) | IL |
VARMARAJ | MERCYCARE INSURANCE (01) | WI |