Provider Demographics
NPI:1700931755
Name:BUDHRAJA, MEENAKSHI (MD)
Entity Type:Individual
Prefix:DR
First Name:MEENAKSHI
Middle Name:
Last Name:BUDHRAJA
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 1:11321 INTERSTATE 30
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72209-7040
Mailing Address - Country:US
Mailing Address - Phone:501-407-2036
Mailing Address - Fax:501-407-2129
Practice Address - Street 1:11321 INTERSTATE 30
Practice Address - Street 2:SUITE 100
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72209-7040
Practice Address - Country:US
Practice Address - Phone:501-407-2036
Practice Address - Fax:501-407-2129
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2015-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR-3893207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARC95840Medicare UPIN