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General NPI Number Information
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NPI Number | 1124516497
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Entity Type | Individual
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Provider Name | MRS. SUMA VARGHESE
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Gender | Female
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Dates
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Enumeration Date | 04/23/2018
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Last Update Date | 04/23/2018
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Provider Practice Location Address
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Address Line | 6701 N CHARLES ST
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City | TOWSON
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State | MD
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Zip | 21204-6808
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Country | US
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Telephone | 443-849-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 9240 HINES ESTATES DR
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City | PARKVILLE
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State | MD
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Zip | 21234-1365
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Country | US
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Telephone | 412-716-3225
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | R173280
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License Number State | MD
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