Doctor Name: | MANILA BAGHERZADEH-AZAR |
NPI Number: | 1679664544 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | E-4060 |
Business Practice Address: | 4301 W Markham St # 783 Little Rock, AR - 722057101 |
Business Phone Number: | 5016868000 |
Business Fax Number: | 5015265148 |
Mailing Address: | 4301 W Markham St # 783, LITTLE ROCK |
State: | AR |
Postal Code: | 722057101 |
Phone Number: | 5016868000 |
Fax Number: | 5015265148 |
NPI Enumeration Date: | 09/27/2006 |
NPI Last Update Date: | 02/27/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2085B0100X |
License Number: | E-4060 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AR |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Radiology |
Taxonomy Specialization: | Body Imaging |
Taxonomy Definition: | A Radiology doctor of Osteopathy that specializes in Body Imaging. |