MEDICARE: MARY JENNY VARUGHESE M.D.

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	207R00000X	Internal Medicine Physician	35090645	OH

General Provider Information

NPI Number	:	1326207911
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY JENNY VARUGHESE M.D.

Provider Business Mailing Address
First Line	:	777 W STATE ST
Second Line	:	SUITE 304
City	:	COLUMBUS
State	:	OH
Zip	:	43222-1536
Country	:	US
Telephone Number	:	614-234-5000
Fax Number	:

Provider Business Practice Location Address
First Line	:	777 W STATE ST
Second Line	:	SUITE 304
City	:	COLUMBUS
State	:	OH
Zip	:	43222-1536
Country	:	US
Telephone Number	:	614-234-5000
Fax Number	:

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

Provider Enumeration Date	:	06/09/2008
Last Update Date	:	02/11/2022

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