Individual
BOBBY VARGHESE MATHEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6565 N CHARLES ST STE 411, TOWSON, MD 21204-5803
(443) 849-3901
(443) 849-3902
Mailing address
7233 ANTARES DR, GAITHERSBURG, MD 20879-5429
(410) 241-4608
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
D0089867
MD
208M00000X
Hospitalist Physician
MD.207130
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2329201
—
LA
Enumeration date
04/03/2013
Last updated
07/09/2020
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