Provider Demographics
NPI:1174363725
Name:POUDEL, BISHAL (MBBS)
Entity type:Individual
Prefix:
First Name:BISHAL
Middle Name:
Last Name:POUDEL
Suffix:
Gender:M
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7301 ROGERS AVE, MERCY HOSPITAL FORT SMITH, ATTN: GME D
Mailing Address - Street 2:
Mailing Address - City:FORTH SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72903
Mailing Address - Country:US
Mailing Address - Phone:479-314-6000
Mailing Address - Fax:479-314-4705
Practice Address - Street 1:7301 ROGERS AVE, MERCY HOSPITAL FORT SMITH, ATTN: GME D
Practice Address - Street 2:
Practice Address - City:FORTH SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903
Practice Address - Country:US
Practice Address - Phone:479-314-6000
Practice Address - Fax:479-314-4705
Is Sole Proprietor?:No
Enumeration Date:2024-05-30
Last Update Date:2025-02-10
Deactivation Date:2025-01-14
Deactivation Code:
Reactivation Date:2025-02-10
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program