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NPI Code Detail

MEDICARE: LIZA R VARGHESE MD

MEDICARE: LIZA R 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
1207RR0500XRheumatology Physician35303KY

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2660003446OTHERKYRR MEDICARE

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 : 1952306193
Entity Type Code : Individual
Provider Name (Legal Business Name) : LIZA R VARGHESE MD
Provider Business Mailing Address
First Line : 2616 LEGENDS WAY
Second Line :
City : CRESTVIEW HILLS
State : KY
Zip : 41017-2418
Country : US
Telephone Number : 859-331-3100
Fax Number : 859-331-9147
Provider Business Practice Location Address
First Line : 2616 LEGENDS WAY
Second Line :
City : CRESTVIEW HILLS
State : KY
Zip : 41017-2418
Country : US
Telephone Number : 859-331-3100
Fax Number : 859-331-9147
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2005
Last Update Date : 10/08/2013

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