Healthcare Provider Details

I. General information

NPI: 1447830419
Provider Name (Legal Business Name): SUZANNE ABOU-DIAB MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2021
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5201 NORTHSHORE DR STE 500
NORTH LITTLE ROCK AR
72118-5312
US

IV. Provider business mailing address

6 WELLINGTON COLONY DR
LITTLE ROCK AR
72211-2090
US

V. Phone/Fax

Practice location:
  • Phone: 501-748-8000
  • Fax:
Mailing address:
  • Phone: 501-563-0575
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberE-20793
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: