Organization
BETHESDA MEDICAL CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHIBU VARUGHESE M.D. (PRESIDENT/MANAGER)
(504) 494-5378
Entity
Organization
Contact information
Practice address
1151 BARATARIA BLVD STE 3400, MARRERO, LA 70072-3083
(504) 265-8304
(504) 309-4193
Mailing address
1151 BARATARIA BLVD STE 3400, MARRERO, LA 70072-3083
(504) 265-8304
(504) 309-4193
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
MD203694
LA
Other
Enumeration date
02/29/2012
Last updated
06/15/2022
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