Healthcare Provider Details

I. General information

NPI: 1154325983
Provider Name (Legal Business Name): MICHAEL PATRICK VARLEY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2005
Last Update Date: 04/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1611 S GREEN RD
SOUTH EUCLID OH
44121-4129
US

IV. Provider business mailing address

1611 S GREEN RD
SOUTH EUCLID OH
44121-4129
US

V. Phone/Fax

Practice location:
  • Phone: 216-362-3366
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number35-050761
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: