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Individual

CHARLES VARGHESE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D

Contact information

Practice address
782 SW SISTERS WELCOME RD, LAKE CITY, FL 32025-0442
(386) 755-4518
(386) 758-4500
Mailing address
782 SW SISTERS WELCOME RD, LAKE CITY, FL 32025-0442
(386) 755-4518
(386) 758-4500

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
ME67182
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
27862
BLUECROSS BLUESHIELD
FL
Enumeration date
08/18/2006
Last updated
07/08/2007
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