Individual
GREGORY S BIENVENU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8907 KANIS RD STE 330, LITTLE ROCK, AR 72205-6451
(501) 224-8810
(501) 224-9076
Mailing address
PO BOX 17930, LITTLE ROCK, AR 72222-7930
(501) 663-0490
(501) 663-5948
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
R-3940
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
115723001
—
AR
01
—
52915
BLUE CROSS BLUE SHIELD
AR
Enumeration date
11/01/2005
Last updated
07/30/2020
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