Provider Demographics
NPI:1861700288
Name:VARGHESE, RANJIT A (MBBS, MS, MHSC)
Entity type:Individual
Prefix:
First Name:RANJIT
Middle Name:A
Last Name:VARGHESE
Suffix:
Gender:M
Credentials:MBBS, MS, MHSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 ORLEANS ST
Mailing Address - Street 2:3110N-7359B-D3
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21287-0010
Mailing Address - Country:US
Mailing Address - Phone:410-955-9216
Mailing Address - Fax:410-502-3944
Practice Address - Street 1:1800 ORLEANS ST
Practice Address - Street 2:3110N-7359B-D3
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-0010
Practice Address - Country:US
Practice Address - Phone:410-955-9216
Practice Address - Fax:410-502-3944
Is Sole Proprietor?:No
Enumeration Date:2010-09-20
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAL-243579207X00000X
MDD74678207XP3100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery