Basic Information
| Provider Information | |||||||||
| NPI: | 1760919872 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MUDDASANI | ||||||||
| FirstName: | ANUSHAREDDY | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1662 HIGDON FERRY RD STE 200 | ||||||||
| Address2: | |||||||||
| City: | HOT SPRINGS | ||||||||
| State: | AR | ||||||||
| PostalCode: | 719136981 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5016232781 | ||||||||
| FaxNumber: | 5016231774 | ||||||||
| Practice Location | |||||||||
| Address1: | 1662 HIGDON FERRY RD STE 200 | ||||||||
| Address2: | |||||||||
| City: | HOT SPRINGS | ||||||||
| State: | AR | ||||||||
| PostalCode: | 719136981 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5016232781 | ||||||||
| FaxNumber: | 5016231774 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/19/2017 | ||||||||
| LastUpdateDate: | 07/28/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/28/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | E-13414 | AR | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.