Provider Demographics
NPI:1255305777
Name:VARAS, THEODORE S (DO)
Entity Type:Individual
Prefix:
First Name:THEODORE
Middle Name:S
Last Name:VARAS
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:BOX 42
Mailing Address - Street 2:601 JOHN STREET
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49007-5341
Mailing Address - Country:US
Mailing Address - Phone:269-341-7806
Mailing Address - Fax:269-341-8743
Practice Address - Street 1:601 JOHN STREET
Practice Address - Street 2:SUITE M302
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49007-5341
Practice Address - Country:US
Practice Address - Phone:269-341-7070
Practice Address - Fax:269-341-7244
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2008-08-15
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Provider Licenses
StateLicense IDTaxonomies
MI5101006905207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0653910705OtherBLUE CROSS BLUE SHIELD
MI25-30538OtherPHYSICIANS HEALTH PLAN
MIM015423OtherCHAMPUS/TRICARE
MI112594845Medicaid
MI0C97618OtherBCBS
MI060006933OtherRAILROAD MEDICARE
MI112594836Medicaid
MI0C97618OtherBCBS
MI112594845Medicaid
MID27285Medicare UPIN