Individual
MATTHEW DENEKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4301 W MARKHAM ST # 783, LITTLE ROCK, AR 72205
(501) 686-8000
(501) 526-4596
Mailing address
4301 W MARKHAM ST # 783, LITTLE ROCK, AR 72205-7199
(501) 686-8000
(501) 526-4596
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
E-4436
AR
207RG0100X
Gastroenterology Physician
107008
MN
207RG0100X
Gastroenterology Physician
Primary
56852
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05060013900
QUALCHOICE
AR
05
—
157947001
—
AR
01
—
5N259
BCBS
AR
01
—
P00295353
RAILROAD MEDICARE1
AR
Enumeration date
10/13/2006
Last updated
09/26/2018
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