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Individual

DR. DANIEL SUNDARESAN PAUL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2708 S RIFE MEDICAL LN STE 200, ROGERS, AR 72758
(479) 338-3080
(479) 338-3089
Mailing address
2708 S RIFE MEDICAL LN STE 200, ROGERS, AR 72758-1456
(479) 338-3080
(479) 338-3089

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
134572
MO
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
134572
MO
207RP1001X
Pulmonary Disease Physician
134572
MO
207RP1001X
Pulmonary Disease Physician
Primary
E11756
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
205149503
MO
01
27053019
BCBS
MO
Enumeration date
02/24/2006
Last updated
05/03/2019
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