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General NPI Number Information
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NPI Number | 1013206747
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Entity Type | Individual
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Provider Name | AMAL K DUDAR PA-C
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Gender | Female
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Dates
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Enumeration Date | 04/04/2011
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Last Update Date | 01/06/2025
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Provider Practice Location Address
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Address Line | 3101 SE 14TH ST
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City | BENTONVILLE
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State | AR
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Zip | 72712-4900
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Country | US
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Telephone | 479-250-1053
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Fax | 479-250-0923
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Provider Business Mailing Address
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Address Line | PO BOX 775641
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City | CHICAGO
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State | IL
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Zip | 60677-5641
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Country | US
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Telephone | 314-543-6979
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Fax | 314-364-6321
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | TC538
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA2136
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 50.003251
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 085006468
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License Number State | IL
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Taxonomy #5
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA-1314
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License Number State | AR
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