Basic Information
Provider Information
NPI: 1811922511
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: VERMA
FirstName: RAJIV
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 635283
Address2:  
City: CINCINNATI
State: OH
PostalCode: 452635283
CountryCode: US
TelephoneNumber: 8599127211
FaxNumber: 8596558981
Practice Location
Address1: 1500 JAMES SIMPSON JR WAY
Address2:  
City: COVINGTON
State: KY
PostalCode: 41011
CountryCode: US
TelephoneNumber: 8599127211
FaxNumber: 8596558981
Other Information
ProviderEnumerationDate: 07/11/2006
LastUpdateDate: 09/04/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X43735KYY Allopathic & Osteopathic PhysiciansInternal Medicine 
207RG0300X43735KYN Allopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
207RG0300X35-086324OHN Allopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
207RH0002X43735KYN Allopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine

ID Information
IDTypeStateIssuerDescription
710018722005KY MEDICAID
P0146953401KYRR MEDICAREOTHER


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