Provider Demographics
NPI:1497837561
Name:MOKARI, BABAK (DO)
Entity Type:Individual
Prefix:
First Name:BABAK
Middle Name:
Last Name:MOKARI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 601067
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-1067
Mailing Address - Country:US
Mailing Address - Phone:704-801-1000
Mailing Address - Fax:704-896-2861
Practice Address - Street 1:12905 ROSEDALE HILL AVE
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-3341
Practice Address - Country:US
Practice Address - Phone:704-801-1000
Practice Address - Fax:704-896-2861
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2001-01105207Q00000X
CA20A8732207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891372FMedicaid
NC2401289FMedicare PIN
NC2401289HMedicare PIN
NC2401289KMedicare PIN
NCNC1624FMedicare PIN
NC2401289EMedicare PIN
NC2401289MMedicare PIN
NCNC1624HMedicare PIN
NCNC1624NMedicare PIN
NC2401289GMedicare PIN
NCNC1624GMedicare PIN
NC2401289NMedicare PIN
NCNC1624DMedicare PIN
NCNC1624IMedicare PIN
NCNC1624JMedicare PIN
NCNC1624LMedicare PIN
NCI17805Medicare UPIN
NCNC1624CMedicare PIN
NCNC1624EMedicare PIN
NC2401289AMedicare PIN
NC2401289CMedicare PIN
NCNC1624AMedicare PIN
NCNC1624KMedicare PIN
NCNC1624PMedicare PIN
NCNC1624BMedicare PIN
NCP00382801Medicare ID - Type UnspecifiedRR-COTSWOLD
NC2401289DMedicare PIN