Provider Demographics
NPI:1831422542
Name:BANSAL, SHIPRA (MD)
Entity type:Individual
Prefix:
First Name:SHIPRA
Middle Name:
Last Name:BANSAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1 CHILDRENS WAY
Mailing Address - Street 2:SLOT 512-6
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72202-3500
Mailing Address - Country:US
Mailing Address - Phone:501-364-1430
Mailing Address - Fax:760-923-7339
Practice Address - Street 1:1 CHILDRENS WAY
Practice Address - Street 2:SLOT 512-6
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72202-3500
Practice Address - Country:US
Practice Address - Phone:501-364-1430
Practice Address - Fax:760-923-7339
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-13
Last Update Date:2017-01-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ARE-97422080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology