Organization
BETHESDA MEDICAL CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHIBU VARUGHESE MD (MEMBER/OWNER)
(504) 265-8304
Entity
Organization
Contact information
Practice address
1620 BELLE CHASSE HWY STE 101, TERRYTOWN, LA 70056-7057
(504) 265-8304
(504) 309-4193
Mailing address
1620 BELLE CHASSE HWY STE 101, TERRYTOWN, LA 70056-7057
(504) 265-8304
(504) 309-4193
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
—
—
207RH0003X
Hematology & Oncology Physician
Primary
—
—
Other
Enumeration date
11/20/2018
Last updated
01/08/2019
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