Healthcare Provider Details

I. General information

NPI: 1669167938
Provider Name (Legal Business Name): NADIA OKOREE-SIAW MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2023
Last Update Date: 04/11/2023
Certification Date: 04/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4301 W MARKHAM ST # 589
LITTLE ROCK AR
72205-7101
US

IV. Provider business mailing address

111 E 4TH ST APT 1306
NORTH LITTLE ROCK AR
72114-5498
US

V. Phone/Fax

Practice location:
  • Phone: 501-526-8148
  • Fax:
Mailing address:
  • Phone: 623-734-5608
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: