Provider Demographics
NPI:1568660660
Name:KARAMI-SICHANI, MOHAMMAD REZA (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMMAD
Middle Name:REZA
Last Name:KARAMI-SICHANI
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 1:10770 EAST BECKER LANE
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85259
Mailing Address - Country:US
Mailing Address - Phone:731-499-0888
Mailing Address - Fax:480-659-5254
Practice Address - Street 1:10770 EAST BECKER LANE
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85269
Practice Address - Country:US
Practice Address - Phone:480-659-0888
Practice Address - Fax:480-659-0714
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-10
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ31022103TP0016X
TN284372084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No103TP0016XBehavioral Health & Social Service ProvidersPsychologistPrescribing (Medical)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ610162Medicaid
TN3724757Medicaid
TN3724757Medicaid