Basic Information
| Provider Information | |||||||||
| NPI: | 1407011802 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | VARKEY | ||||||||
| FirstName: | SANTOSH | ||||||||
| MiddleName: | C | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 818 SAINT SEBASTIAN WAY | ||||||||
| Address2: | SUITE 311 | ||||||||
| City: | AUGUSTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 309012651 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7067243473 | ||||||||
| FaxNumber: | 7067243793 | ||||||||
| Practice Location | |||||||||
| Address1: | 818 SAINT SEBASTIAN WAY | ||||||||
| Address2: | SUITE 311 | ||||||||
| City: | AUGUSTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 309012651 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7067243473 | ||||||||
| FaxNumber: | 7067243493 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/24/2008 | ||||||||
| LastUpdateDate: | 10/20/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 072464 | GA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RC0000X | 072464 | GA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 207RC0001X | 072464 | GA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Clinical Cardiac Electrophysiology |
ID Information
| ID | Type | State | Issuer | Description | 003149849B | 05 | GA | MEDICAID |