Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | E-14337 | AR |
N | 207PP0204X | Pediatric Emergency Physician | MD470309 | PA |
N | 208000000X | Pediatrician | E-14337 | AR |
NPI | 1336554641 |
---|---|
Provider Name | Dr. Maher Mohammad K. Abulfaraj |
First Address | Little Rock, AR 72225-1418 |
Second Address | Little Rock, AR 72202-3500 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2014 |
Last Update Date | 25/08/2021 |