Provider Demographics
NPI:1225073596
Name:KABANI, NOORMAHAL (MD)
Entity Type:Individual
Prefix:DR
First Name:NOORMAHAL
Middle Name:
Last Name:KABANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3801 CAMDEN RD
Mailing Address - Street 2:SUITE 22
Mailing Address - City:PINE BLUFF
Mailing Address - State:AR
Mailing Address - Zip Code:71603-4612
Mailing Address - Country:US
Mailing Address - Phone:870-879-3007
Mailing Address - Fax:
Practice Address - Street 1:3801 CAMDEN RD
Practice Address - Street 2:SUITE 22
Practice Address - City:PINE BLUFF
Practice Address - State:AR
Practice Address - Zip Code:71603-4612
Practice Address - Country:US
Practice Address - Phone:870-879-3007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE2334207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR140511001Medicaid
AR5L312OtherBLUE CROSS
AR5L312Medicare PIN