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Individual

SHASHIDHAR MANCHEGOWDA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4301 W MARKHAM ST # 515, LITTLE ROCK, AR 72205-7101
(501) 686-6114
(501) 686-8139
Mailing address
4301 W MARKHAM ST # 783, LITTLE ROCK, AR 72205-7101
(501) 686-8000
(501) 526-5148

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
E-15663
AR
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
Primary
E-15663
AR
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
07/12/2019
Last updated
09/29/2022
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