MEDICARE: REUBEN KORAH 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	2083P0901X	Public Health & General Preventive Medicine Physician	0101232386	VA

General Provider Information

NPI Number	:	1427463348
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REUBEN KORAH VARGHESE MD

Provider Business Mailing Address
First Line	:	2100 WASHINGTON BLVD
Second Line	:	4TH FLOOR
City	:	ARLINGTON
State	:	VA
Zip	:	22204-5703
Country	:	US
Telephone Number	:	703-228-1611
Fax Number	:	703-228-1117

Provider Business Practice Location Address
First Line	:	800 S WALTER REED DR
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22204-2308
Country	:	US
Telephone Number	:	703-228-1600
Fax Number	:	703-228-1117

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

Provider Enumeration Date	:	06/30/2014
Last Update Date	:	06/30/2014

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