# BETHESDA MEDICAL CLINIC, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912271412
- **Authorized official:** DR. SHIBU VARUGHESE M.D. (PRESIDENT/MANAGER)
- **Authorized official phone:** (504) 494-5378

## Contact information

- **Practice address:** 1151 BARATARIA BLVD STE 3400, MARRERO, LA 70072-3083
- **Practice address phone:** (504) 265-8304
- **Practice address fax:** (504) 309-4193
- **Mailing address:** 1151 BARATARIA BLVD STE 3400, MARRERO, LA 70072-3083
- **Mailing address phone:** (504) 265-8304
- **Mailing address fax:** (504) 309-4193

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | MD203694 | LA | Yes |

## Other

- **Enumeration date:** 02/29/2012
- **Last updated:** 06/15/2022