Provider Demographics
NPI:1255419115
Name:PARACHA, MOHAMMAD I (MD)
Entity type:Individual
Prefix:
First Name:MOHAMMAD
Middle Name:I
Last Name:PARACHA
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 1:2801 PARKLAWN DR STE 301
Mailing Address - Street 2:
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73110-4230
Mailing Address - Country:US
Mailing Address - Phone:405-737-8204
Mailing Address - Fax:405-737-4109
Practice Address - Street 1:4221 S WESTERN AVE STE 2045
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73109-3445
Practice Address - Country:US
Practice Address - Phone:405-631-5188
Practice Address - Fax:405-631-5952
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK21878207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100011910AMedicaid
OK100011910AMedicaid