Individual
SARAH MARDANLOU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
610 KITTY HAWK ST, VAN BUREN, AR 72956-2132
(479) 719-0562
Mailing address
610 KITTY HAWK ST, VAN BUREN, AR 72956-2132
(479) 719-0562
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
27706
WV
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/08/2015
Last updated
03/11/2019
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