Healthcare Provider Details

I. General information

NPI: 1275461071
Provider Name (Legal Business Name): MIAN PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14315 OVERCREEK PASS
LITTLE ROCK AR
72211-3891
US

IV. Provider business mailing address

14315 OVERCREEK PASS
LITTLE ROCK AR
72211-3891
US

V. Phone/Fax

Practice location:
  • Phone: 773-754-5538
  • Fax:
Mailing address:
  • Phone: 773-754-5538
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MOHSIN ALTAF
Title or Position: OWNER/MD
Credential:
Phone: 773-754-5538