Individual
DR. REGI VARGHESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 MALLARD CREEK RD STE 320, LOUISVILLE, KY 40207-5136
(502) 855-6125
(502) 394-1972
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 272-5395
(502) 272-5339
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01046412A
IN
207R00000X
Internal Medicine Physician
Primary
33222
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110150805
RAILROAD MEDICARE
KY
05
—
64332224
—
KY
01
—
P00476429
RAILROAD MEDICARE PTAN
KY
Enumeration date
04/17/2006
Last updated
09/13/2021
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