MEDICARE: DR. MEENAKSHI BUDHRAJA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	R-3893	AR

General Provider Information

NPI Number	:	1700931755
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MEENAKSHI BUDHRAJA MD

Provider Business Mailing Address
First Line	:	11321 INTERSTATE 30
Second Line	:	SUITE 100
City	:	LITTLE ROCK
State	:	AR
Zip	:	72209-7040
Country	:	US
Telephone Number	:	501-407-2036
Fax Number	:	501-407-2129

Provider Business Practice Location Address
First Line	:	11321 INTERSTATE 30
Second Line	:	SUITE 100
City	:	LITTLE ROCK
State	:	AR
Zip	:	72209-7040
Country	:	US
Telephone Number	:	501-407-2036
Fax Number	:	501-407-2129

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/23/2007
Last Update Date	:	02/19/2015

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