MEDICARE: SONIA JOHN VARGHESE MD

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	27812	OK
2	207RH0003X	Hematology & Oncology Physician	27812	OK

General Provider Information

NPI Number	:	1396065405
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SONIA JOHN VARGHESE MD

Provider Business Mailing Address
First Line	:	4401 MCAULEY BLVD
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73120-8341
Country	:	US
Telephone Number	:	405-751-4343
Fax Number	:	405-751-4346

Provider Business Practice Location Address
First Line	:	4401 MCAULEY BLVD
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73120-8341
Country	:	US
Telephone Number	:	405-751-4343
Fax Number	:	405-751-4346

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

Provider Enumeration Date	:	06/11/2010
Last Update Date	:	08/09/2016

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