Provider Demographics
NPI:1518373802
Name:MUNAWAR, AZKA (MD)
Entity Type:Individual
Prefix:
First Name:AZKA
Middle Name:
Last Name:MUNAWAR
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 1:6834 CANTRELL RD STE 1180
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72207-4135
Mailing Address - Country:US
Mailing Address - Phone:786-309-5157
Mailing Address - Fax:
Practice Address - Street 1:6834 CANTRELL RD STE 1180
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72207-4135
Practice Address - Country:US
Practice Address - Phone:786-309-5157
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-08
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-134812084P0800X, 2084P0805X
PAMT207342390200000X
PAMD4651462084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program