Healthcare Provider Details

I. General information

NPI: 1821292319
Provider Name (Legal Business Name): ABUL KAMAL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2007
Last Update Date: 08/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2, SAINT VINCENT CIRCLE SAINT VINCENT HOSPITAL, HOSPITALIST OFFICE
LITTLE ROCK AR
72205
US

IV. Provider business mailing address

12924 RIDGEHAVEN RD
LITTLE ROCK AR
72211-2210
US

V. Phone/Fax

Practice location:
  • Phone: 501-552-4677
  • Fax: 501-552-4555
Mailing address:
  • Phone: 501-664-0300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberE-6931
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: