Individual
PRIYA MENDIRATTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4301 W MARKHAM ST, UAMS #783, LITTLE ROCK, AR 72205-7101
(501) 686-8000
(501) 526-6562
Mailing address
4301 W MARKHAM ST, UAMS #783, LITTLE ROCK, AR 72205-7101
(501) 686-8000
(501) 526-6562
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
E-4389
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
162840001
—
AR
01
—
P00351553
RAILROAD MEDICARE
AR
Enumeration date
09/22/2006
Last updated
12/19/2014
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