MEDICARE: ROSEMARY JOSEPH VERGHESE 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	D0069811	MD
2	207N00000X	Dermatology Physician	D0069811	MD

General Provider Information

NPI Number	:	1942477559
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROSEMARY JOSEPH VERGHESE M.D

Provider Business Mailing Address
First Line	:	777 7TH ST NW APT 824
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20001-5709
Country	:	US
Telephone Number	:	703-899-5510
Fax Number	:

Provider Business Practice Location Address
First Line	:	173 SAINT PATRICKS DR
Second Line	:	SUITE 201
City	:	WALDORF
State	:	MD
Zip	:	20603-5529
Country	:	US
Telephone Number	:	301-396-3401
Fax Number	:

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

Provider Enumeration Date	:	05/13/2008
Last Update Date	:	03/07/2012

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