Provider Demographics
NPI:1174221287
Name:VARKEY, GEOGE PURAIDAM (MDIV)
Entity type:Individual
Prefix:
First Name:GEOGE
Middle Name:PURAIDAM
Last Name:VARKEY
Suffix:
Gender:M
Credentials:MDIV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6114 LAUSCHE AVE APT 214
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44103-1590
Mailing Address - Country:US
Mailing Address - Phone:216-791-3800
Mailing Address - Fax:216-229-2956
Practice Address - Street 1:CLEVELAND VA MEDICAL CENTER
Practice Address - Street 2:10701 EAST BLVD.
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1590
Practice Address - Country:US
Practice Address - Phone:216-791-3800
Practice Address - Fax:216-229-2956
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-17
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374K00000XNursing Service Related ProvidersReligious Nonmedical PractitionerGroup - Single Specialty