Healthcare Provider Details

I. General information

NPI: 1336999648
Provider Name (Legal Business Name): AHMED S. NEGM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2024
Last Update Date: 03/27/2024
Certification Date: 03/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4301 W MARKHAM ST
LITTLE ROCK AR
72205-7199
US

IV. Provider business mailing address

4301 W MARKHAM ST # 556
LITTLE ROCK AR
72205-7199
US

V. Phone/Fax

Practice location:
  • Phone: 501-686-7000
  • Fax:
Mailing address:
  • Phone: 501-603-1595
  • Fax: 501-686-6900

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: