Individual
GABRIEL MATONBA PEAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 S UNIVERSITY AVE STE 720, LITTLE ROCK, AR 72205-5345
(501) 558-4900
(501) 558-4909
Mailing address
500 S UNIVERSITY AVE STE 720, LITTLE ROCK, AR 72205-5345
(501) 558-4900
(501) 558-4909
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
E1660
AR
208C00000X
Colon & Rectal Surgery Physician
Primary
E1660
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
133831001
—
AR
01
—
1609260157
GROUP NPI
AR
01
—
485340
MEDICARE
AR
01
—
485357
MEDICARE INDIVIDUAL PTAN
AR
Enumeration date
01/31/2006
Last updated
03/07/2023
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