Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 40740 | SC |
N | 111NI0900X | Internist | 40740 | SC |
Y | 207RG0300X | Geriatric Medicine | 40740 | SC |
NPI | 1093156580 |
---|---|
Provider Name | Vipin Verma |
First Address | Anderson, SC 29621-5705 |
Second Address | Anderson, SC 29621-5705 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2013 |
Last Update Date | 11/04/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
407401 | (05) | SC |