Individual
MRS. MARY LAUREL VARGHESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
6 S POINSETT HWY, TRAVELERS REST INTERNAL MEDICINE, TRAVELERS REST, SC 29690-1822
(864) 834-7834
(864) 834-7477
Mailing address
PO BOX 743294, ATLANTA, GA 30374-3294
(864) 834-7834
(864) 834-7477
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
20185
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003140025A
—
GA
05
—
NP3996
—
SC
Enumeration date
07/05/2013
Last updated
11/10/2016
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