# DR. JOHN VARGAS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1063692044
- **Gender:** Man
- **Credential:** D.O.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | JV005853 | MI | Yes |

## Other

- **Enumeration date:** 11/07/2007
- **Last updated:** 04/23/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0155628580 | BLUE CROSS BLUE SHIELD | MI |
| 05 | — | 2991184 | — | MI |