Provider Demographics
NPI:1588088579
Name:VARGHESE, SARAH K I (MD)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:K
Last Name:VARGHESE
Suffix:I
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12245 FREDERICK RD
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-1050
Mailing Address - Country:US
Mailing Address - Phone:410-442-4056
Mailing Address - Fax:410-442-4058
Practice Address - Street 1:12245 FREDERICK RD
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-1050
Practice Address - Country:US
Practice Address - Phone:410-442-4056
Practice Address - Fax:410-442-4058
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-11
Last Update Date:2014-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDOO18983207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine