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1952006843
IDEAN POURSHAMS
FAYETTEVILLE, AR
NPI
1952006843
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2023-03-31
Last Update Date
2023-03-31
Business Address
DR. IDEAN POURSHAMS MD
1125 N COLLEGE AVE # SLOT100
FAYETTEVILLE, AR 72703-1908
Phone number: 479-713-8310
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Mailing Address
DR. IDEAN POURSHAMS MD
1125 N COLLEGE AVE # SLOT100
FAYETTEVILLE, AR 72703-1908
Phone number:
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