Provider Demographics
NPI:1871552083
Name:SHRESTHA, BAL N (MD)
Entity type:Individual
Prefix:DR
First Name:BAL
Middle Name:N
Last Name:SHRESTHA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:476 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:AR
Mailing Address - Zip Code:71701-4616
Mailing Address - Country:US
Mailing Address - Phone:870-836-8221
Mailing Address - Fax:870-836-8148
Practice Address - Street 1:476 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:AR
Practice Address - Zip Code:71701-4616
Practice Address - Country:US
Practice Address - Phone:870-836-8221
Practice Address - Fax:870-836-8148
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-17
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARR3705208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery