Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0001X | Clinical Cardiac Electrophysiologist | 29782 | AL |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | ME86050 | FL |
NPI | 1225038557 |
---|---|
Provider Name | Sumit Verma |
First Address | Pensacola, FL 32501-6339 |
Second Address | Pensacola, FL 32501-6339 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2005 |
Last Update Date | 18/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
009940985 | (05) | AL |
2653711 00 | (05) | FL |
H74003 | (02) | FL |