Provider Demographics
NPI:1932415379
Name:MOREY VARGAS, OSCAR LEOPOLDO (MD)
Entity Type:Individual
Prefix:DR
First Name:OSCAR
Middle Name:LEOPOLDO
Last Name:MOREY VARGAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17270 BUCKTHORN DR
Mailing Address - Street 2:
Mailing Address - City:CHAGRIN FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44023-1412
Mailing Address - Country:US
Mailing Address - Phone:773-899-6788
Mailing Address - Fax:
Practice Address - Street 1:3733 PARK EAST DR
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-4338
Practice Address - Country:US
Practice Address - Phone:216-504-0001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-24
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125055243207R00000X
OH35.140593207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN460000443Medicare PIN