Provider Demographics
NPI:1629098496
Name:OCH, MOHAMAD R (MD)
Entity Type:Individual
Prefix:
First Name:MOHAMAD
Middle Name:R
Last Name:OCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:108 GROVE ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605-2651
Mailing Address - Country:US
Mailing Address - Phone:508-753-3220
Mailing Address - Fax:508-753-3224
Practice Address - Street 1:425 LAKE AVE N STE 101
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-2047
Practice Address - Country:US
Practice Address - Phone:508-753-3220
Practice Address - Fax:508-753-3224
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA534302084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJO4234Medicare ID - Type Unspecified
J04234Medicare PIN