Provider Demographics
NPI:1639258379
Name:CHERIAN, MATHEW AMPRAYIL (MD)
Entity type:Individual
Prefix:
First Name:MATHEW
Middle Name:AMPRAYIL
Last Name:CHERIAN
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 1:800 NE 10TH ST STE 3010
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73104-5418
Mailing Address - Country:US
Mailing Address - Phone:405-271-8778
Mailing Address - Fax:405-271-2724
Practice Address - Street 1:800 NE 10TH ST STE 3010
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-5418
Practice Address - Country:US
Practice Address - Phone:405-271-8778
Practice Address - Fax:405-271-2724
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2025-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK46352207RX0202X
OH35.133906207RX0202X
MO2009006300207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0289386Medicaid
ILENROLLEDMedicaid