Provider Demographics
NPI:1790037141
Name:VARMA, MALVIKA (MD)
Entity type:Individual
Prefix:DR
First Name:MALVIKA
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:PO BOX 245027
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85724-5027
Mailing Address - Country:US
Mailing Address - Phone:520-626-9660
Mailing Address - Fax:520-626-0107
Practice Address - Street 1:1501 N CAMPBELL AVE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85724-3328
Practice Address - Country:US
Practice Address - Phone:520-626-9660
Practice Address - Fax:520-626-0107
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-10
Last Update Date:2018-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125057958390200000X
AZ57192207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program