Individual
EJAZ ALAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9601 BAPTIST HEALTH DRIVE, LITTLE ROCK, AR 72205-6321
(501) 851-7402
(501) 851-4753
Mailing address
11001 EXECUTIVE CENTER DRIVE, SUITE 200, LITTLE ROCK, AR 72211-4393
(501) 812-7215
(501) 812-7207
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
E4578
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
162025001
—
AR
Enumeration date
09/22/2006
Last updated
02/13/2020
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