Provider Demographics
NPI:1023145554
Name:VARMA, RUPA ALLAM (MD)
Entity type:Individual
Prefix:DR
First Name:RUPA
Middle Name:ALLAM
Last Name:VARMA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2101 EAST JEFFERSON STREET
Mailing Address - Street 2:KAISER PERMANENTE, PPQA, 6 WEST, ATTN: KENNETH STANARD
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4908
Mailing Address - Country:US
Mailing Address - Phone:301-816-7405
Mailing Address - Fax:855-902-6965
Practice Address - Street 1:1221 MERCANTILE AVENUE
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:MD
Practice Address - Zip Code:20774
Practice Address - Country:US
Practice Address - Phone:301-618-5500
Practice Address - Fax:301-618-5673
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD43211207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G20425Medicare UPIN
K679G946Medicare ID - Type Unspecified
017123K32Medicare ID - Type Unspecified