Individual
NIKITHA MANEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1001 TOWSON AVE, FORT SMITH, AR 72901-4921
(479) 441-5005
(479) 441-4917
Mailing address
11001 EXECUTIVE CENTER DR, LITTLE ROCK, AR 72211-4316
(479) 441-5005
(479) 441-4917
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
E-15707
AR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/31/2019
Last updated
09/09/2022
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