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General NPI Number Information
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NPI Number | 1093193161
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Entity Type | Individual
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Provider Name | GIRISH CHINTAMANI MOHAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/11/2015
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Last Update Date | 02/21/2025
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Provider Practice Location Address
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Address Line | 9245 S MINGO RD
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City | TULSA
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State | OK
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Zip | 74133-5793
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Country | US
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Telephone | 918-492-8980
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Fax | 918-495-0607
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Provider Business Mailing Address
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Address Line | 110 W 7TH ST STE 2520
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City | TULSA
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State | OK
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Zip | 74119-1104
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Country | US
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Telephone | 918-579-3826
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Fax | 918-579-1262
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 62550
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | A170186
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207ND0101X
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Taxonomy Name | MOHS-Micrographic Surgery Physician
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License Number | 62550
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License Number State | CT
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Taxonomy #4
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Taxonomy Code | 207NS0135X
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Taxonomy Name | Procedural Dermatology Physician
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License Number | 62550
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License Number State | CT
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Taxonomy #5
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 44353
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License Number State | OK
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