Maham Bakhtyar

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Little Rock, AR

NPI 1972234839 · NPPES record last updated Jun 22, 2022

Key facts

NPI
1972234839
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
4301 W Markham St # 634
Little Rock, AR 72205-7101
Phone
(501) 686-7592
NPI assigned
Jun 22, 2022
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20220803000332 AR Order and Referring Only - Internal Medicine
Practitioner - Internal Medicine
3476935743

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

4301 W Markham St # 634
Little Rock, AR 72205-7101

Mailing address

701 Rahling Rd Apt 3419
Little Rock, AR 72223-4034
Phone (913) 228-9640

Other providers in Little Rock, AR

All providers in Little Rock, AR · Student in an Organized Health Care Education/Training Program in Arkansas

Sources for this page

Verify at the official NPI Registry.