Organization
PSYCHOLOGICAL MEDICINE CLINIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISHNA M VERMA M.D. (MD - PSYCHIATRIST)
(252) 291-6200
Entity
Organization
Contact information
Practice address
1810 WESTWOOD AVE W, WILSON, NC 27893-2143
(252) 291-6200
(252) 291-2147
Mailing address
1810 WESTWOOD AVE W, WILSON, NC 27893-2143
(252) 291-6200
(252) 291-2147
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2157403B
MEDICARE P-TAN
NC
05
—
8985003
—
NC
Enumeration date
02/09/2007
Last updated
11/14/2013
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