Provider Demographics
NPI:1710205000
Name:VARMA, DIVYASHREE (MD)
Entity type:Individual
Prefix:DR
First Name:DIVYASHREE
Middle Name:
Last Name:VARMA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10645 N TATUM BLVD # 200
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85028-3068
Mailing Address - Country:US
Mailing Address - Phone:315-882-0534
Mailing Address - Fax:
Practice Address - Street 1:1930 E THOMAS RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-7711
Practice Address - Country:US
Practice Address - Phone:605-532-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-11
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ58467207RC0000X, 207RC0001X
MI4301111507207RC0000X
TXQ9260207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX361116201Medicaid
TX361116202OtherCSHCN
TX361116202OtherCSHCN