Provider Demographics
NPI:1891765079
Name:BARVE, ARCHANA (MD)
Entity Type:Individual
Prefix:DR
First Name:ARCHANA
Middle Name:
Last Name:BARVE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3613 NW 56TH ST
Mailing Address - Street 2:SUITE 140
Mailing Address - City:OKC
Mailing Address - State:OK
Mailing Address - Zip Code:73112
Mailing Address - Country:US
Mailing Address - Phone:405-949-6481
Mailing Address - Fax:405-795-5909
Practice Address - Street 1:3613 NW 56TH ST
Practice Address - Street 2:SUITE 140
Practice Address - City:OKC
Practice Address - State:OK
Practice Address - Zip Code:73112
Practice Address - Country:US
Practice Address - Phone:405-949-6481
Practice Address - Fax:405-795-5909
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-23
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK06-1731541208100000X
OK20734208100000X, 2081P0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2081P0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPediatric Rehabilitation Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100132060AMedicaid
OK207Q00000XMedicare ID - Type Unspecified
OKG16574Medicare UPIN