Healthcare Provider Details

I. General information

NPI: 1639258379
Provider Name (Legal Business Name): MATHEW AMPRAYIL CHERIAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2006
Last Update Date: 11/25/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 NE 10TH ST STE 3010
OKLAHOMA CITY OK
73104-5418
US

IV. Provider business mailing address

800 NE 10TH ST STE 3010
OKLAHOMA CITY OK
73104-5418
US

V. Phone/Fax

Practice location:
  • Phone: 405-271-8778
  • Fax: 405-271-2724
Mailing address:
  • Phone: 405-271-8778
  • Fax: 405-271-2724

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number46352
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number35.133906
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number2009006300
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: