Provider Demographics
NPI:1245211481
Name:MATHEW, VARKEY (MD)
Entity Type:Individual
Prefix:DR
First Name:VARKEY
Middle Name:
Last Name:MATHEW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:3995 OLD TOWN RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:HUNTINGTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20639-9407
Mailing Address - Country:US
Mailing Address - Phone:410-535-3612
Mailing Address - Fax:410-535-3613
Practice Address - Street 1:3995 OLD TOWN RD
Practice Address - Street 2:SUITE 101
Practice Address - City:HUNTINGTOWN
Practice Address - State:MD
Practice Address - Zip Code:20639-3039
Practice Address - Country:US
Practice Address - Phone:410-535-3612
Practice Address - Fax:410-535-3613
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2015-12-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0045435207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD516POtherGROUP MEDICARE MD NUMBER
MD4173341P001Medicaid
MD516P004HMedicare PIN