Provider Demographics
NPI:1225345994
Name:VARGHESE, ROBIN (MBBS, MD)
Entity Type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:
Last Name:VARGHESE
Suffix:
Gender:M
Credentials:MBBS, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 S HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:MURPHYSBORO
Mailing Address - State:IL
Mailing Address - Zip Code:62966-3333
Mailing Address - Country:US
Mailing Address - Phone:618-684-3156
Mailing Address - Fax:618-684-1040
Practice Address - Street 1:2 S HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:MURPHYSBORO
Practice Address - State:IL
Practice Address - Zip Code:62966-3333
Practice Address - Country:US
Practice Address - Phone:618-684-3156
Practice Address - Fax:618-684-1040
Is Sole Proprietor?:No
Enumeration Date:2010-09-01
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1744R1102X
IL036.135858207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No1744R1102XOther Service ProvidersSpecialistResearch Study
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
214881Medicare Oscar/Certification