Provider Demographics
NPI:1376260968
Name:NOYDEEN MEDICAL GROUP - LITTLE ROCK
Entity Type:Organization
Organization Name:NOYDEEN MEDICAL GROUP - LITTLE ROCK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-370-1992
Mailing Address - Street 1:1100 N UNIVERSITY AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72207-6360
Mailing Address - Country:US
Mailing Address - Phone:501-209-4040
Mailing Address - Fax:
Practice Address - Street 1:1100 N UNIVERSITY AVE STE 200
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72207-6360
Practice Address - Country:US
Practice Address - Phone:501-209-4040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NOYDEEN SISTERS MEDICAL GROUP & CLINICS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-10-24
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty