MEDICARE: TINA VARGHESE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	77579	GA
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1780002725
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TINA VARGHESE

Provider Business Mailing Address
First Line	:	275 COLLIER RD NW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30309-1709
Country	:	US
Telephone Number	:	404-605-2800
Fax Number	:

Provider Business Practice Location Address
First Line	:	275 COLLIER RD NW STE 500
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30309-1711
Country	:	US
Telephone Number	:	404-605-2800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/06/2014
Last Update Date	:	01/12/2026

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Directions to “ TINA VARGHESE ” Practice Location

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