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NPI Code Detail

MEDICARE: JERRY VARGHESE MD

MEDICARE:   JERRY  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
1207R00000XInternal Medicine Physician35085028OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1841279874
Entity Type Code : Individual
Provider Name (Legal Business Name) : JERRY VARGHESE MD
Provider Business Mailing Address
First Line : 7141 SECURITY BLVD
Second Line :
City : BALTIMORE
State : MD
Zip : 21244-1811
Country : US
Telephone Number : 443-663-6000
Fax Number : 443-663-6215
Provider Business Practice Location Address
First Line : 7141 SECURITY BLVD
Second Line :
City : BALTIMORE
State : MD
Zip : 21244-1811
Country : US
Telephone Number : 443-663-6000
Fax Number : 443-663-6215
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2006
Last Update Date : 06/08/2021

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Directions to “ JERRY VARGHESE MD” Practice Location

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