Individual
SHIVA NALLUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10301 KANIS RD STE 1, LITTLE ROCK, AR 72205-6205
(501) 562-4838
(501) 562-1958
Mailing address
10301 KANIS RD STE 1, LITTLE ROCK, AR 72205-6205
(501) 562-4838
(501) 562-1958
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E5407
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
174913001
—
AR
Enumeration date
04/04/2007
Last updated
09/27/2024
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