Provider Demographics
NPI:1124027776
Name:VARGHAI, MOHAMMAD ALI (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMMAD
Middle Name:ALI
Last Name:VARGHAI
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 1:2420 LAKE AVE
Mailing Address - Street 2:
Mailing Address - City:ASHTABULA
Mailing Address - State:OH
Mailing Address - Zip Code:44004-4954
Mailing Address - Country:US
Mailing Address - Phone:440-994-7600
Mailing Address - Fax:440-994-7603
Practice Address - Street 1:2420 LAKE AVE
Practice Address - Street 2:
Practice Address - City:ASHTABULA
Practice Address - State:OH
Practice Address - Zip Code:44004-4954
Practice Address - Country:US
Practice Address - Phone:440-994-7600
Practice Address - Fax:440-994-7603
Is Sole Proprietor?:No
Enumeration Date:2005-07-16
Last Update Date:2011-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-053339207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000390417OtherANTHEM
OH002081415OtherHIGHMARK
OH0858602Medicaid
OH000000390417OtherANTHEM
OHVA0627691Medicare PIN
OHE07223Medicare UPIN