Provider Demographics
NPI:1043314362
Name:VARMA, VIVEK KUMAR (MD)
Entity type:Individual
Prefix:DR
First Name:VIVEK
Middle Name:KUMAR
Last Name:VARMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:816 22ND AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68845-2206
Mailing Address - Country:US
Mailing Address - Phone:308-865-2263
Mailing Address - Fax:308-865-2541
Practice Address - Street 1:206 SOUTH STREET
Practice Address - Street 2:SUITE C
Practice Address - City:ELKTON
Practice Address - State:MD
Practice Address - Zip Code:21921
Practice Address - Country:US
Practice Address - Phone:410-620-4920
Practice Address - Fax:410-620-4922
Is Sole Proprietor?:No
Enumeration Date:2006-09-08
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE32547207RI0011X
KS04-44541207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDP00188059OtherRAILROAD MEDICARE
MD406558100Medicaid
DEG01901V01Medicare PIN
MD048N893FMedicare PIN
MD048N893FMedicare ID - Type Unspecified
DEG01901V01Medicare ID - Type Unspecified
MDP00188059OtherRAILROAD MEDICARE