Individual
ELSIE VARUGHESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
63 MAIN ST, BROCKTON, MA 02301-4012
(508) 559-6699
(508) 583-4649
Mailing address
63 MAIN ST, BROCKTON, MA 02301-4042
(508) 559-6699
(508) 559-5073
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
51397
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002630
NEIGHBORHOOD HEALTH PLAN
—
01
—
25494
HEALTHY START
—
01
—
J04795
BLUE CROSS AND BLUE SHIEL
—
Enumeration date
06/19/2006
Last updated
12/16/2011
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