Individual
SHILPA MOHANAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4301 W MARKHAM ST, LITTLE ROCK, AR 72205-7199
(501) 400-3205
Mailing address
15418 HARTFORD ST, LITTLE ROCK, AR 72223-7219
(501) 400-3205
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
102683
GA
390200000X
Student in an Organized Health Care Education/Training Program
BP10069455
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
AR
Other
Enumeration date
07/13/2019
Last updated
05/01/2025
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