Provider Demographics
NPI:1205844594
Name:EMANUEL, PETER D (MD)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:D
Last Name:EMANUEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10001 LILE DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-6217
Mailing Address - Country:US
Mailing Address - Phone:501-552-6100
Mailing Address - Fax:501-552-6199
Practice Address - Street 1:10001 LILE DR
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6217
Practice Address - Country:US
Practice Address - Phone:501-552-6100
Practice Address - Fax:501-552-6199
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-5381207RH0003X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000016296OtherBLUE CROSS
AR7316OtherUAMS HOSPITAL
ARP00466617OtherRAILROAD MEDICARE
AL000016296Medicaid
ALC73314OtherVIVA
AR166109001Medicaid
AL009914995Medicaid
MS0111299OtherMISSISSIPPI MEDICAID
AL110036176OtherRAILROAD MEDICARE
AR24B05OtherMCGP BILLING
AL18585OtherHEALTHSPRING OF ALABAMA
AL051513428OtherBLUE CROSSA
AL000016296Medicare ID - Type Unspecified
AL000016296Medicaid