Individual
DR. SUDESH BANAJI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
332 E COOK ST, FORREST CITY, AR 72335-2830
(870) 630-2233
(870) 630-2224
Mailing address
332 EAST COOK STREET, FORREST CITY, AR 72335-9183
(870) 630-2233
(870) 630-2224
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
E-2308
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
138381001
—
AR
01
—
5F219
AR BCBS
AR
Enumeration date
07/20/2005
Last updated
08/19/2013
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