Individual
DR. SURENDRAN RAJA RAJA VARMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
625 CLARK AVE, BRISTOL, CT 06010-4068
(860) 583-7700
(860) 589-7656
Mailing address
625 CLARK AVE, BRISTOL, CT 06010-4068
(860) 583-7700
(860) 589-7656
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
232460
NY
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
043632
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02592556
—
NY
05
—
1891795316
—
CT
Enumeration date
07/27/2005
Last updated
05/02/2023
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